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Sample records for intussuscepting terminal ileal

  1. Midgut pain due to an intussuscepting terminal ileal lipoma: a case report.

    LENUS (Irish Health Repository)

    Abbasakoor, Noormuhammad O

    2010-01-01

    ABSTRACT: INTRODUCTION: The occurrence of intussusception in adults is rare. The condition is found in 1 in 1300 abdominal operations and 1 in 100 patients operated for intestinal obstruction. The child to adult ratio is 20:1. CASE PRESENTATION: A 52-year-old Irish Caucasian woman was investigated for a 3-month history of intermittent episodes of colicky midgut pain and associated constipation. Ileocolonoscopy revealed a pedunculated lesion in the terminal ileum prolapsing into the caecum. Computed tomography confirmed a smooth-walled, nonobstructing, low density intramural lesion in the terminal ileum with secondary intussusception. A laparoscopic small bowel resection was performed. Histology revealed a large pedunculated polypoidal mass measuring 4 x 2.5 x 2 cm consistent with a submucosal lipoma. She had complete resolution of her symptoms and remained well at 12-month follow-up. CONCLUSION: This case highlights an unusual cause of incomplete small bowel obstruction successfully treated through interdisciplinary cooperation. Ileal lipomas are not typically amenable to endoscopic removal and require resection. This can be successfully achieved via a laparoscopic approach with early restoration of premorbid functioning.

  2. Ileoileal Intussusception Secondary to an Ileal Fibroma

    Directory of Open Access Journals (Sweden)

    Haritha Chelimilla

    2012-11-01

    Full Text Available Intussusception is defined as the telescoping of a segment of the gastrointestinal tract (intussusceptum into an immediately adjacent distal bowel (intussuscipiens. Intussusception is a relatively rare cause of intestinal obstruction in adults. Unlike in children, a lead point is present in 90% of adult cases. The most common causes of small bowel intussusception are benign, usually hamartomas, lipomas, inflammatory polyps, adenomas and leiomyomas, in contrast to the large intestine where malignant tumors, usually adenocarcinomas, are more common. The clinical presentation of adult intussusception is non-specific with variable manifestations, predominantly those of intestinal obstruction, often making the diagnosis a challenge. The onset of symptoms may be acute, intermittent or chronic. We present a rare case of an ileal fibroma presenting with intussusception. A 43-year-old woman presented to our outpatient clinic with a history of recurrent abdominal pain. The clinical presentation and CT scan findings led to the diagnosis of ileoileal intussusception. Subsequently she underwent laparotomy which revealed an ileal fibroma as the lead point of the intussusception. Surgical exploration remains essential for diagnosis and treatment since in the majority of cases a pathologic lead point is identified. Ileal fibroma is an uncommon benign neoplasm of the small bowel and must be considered in the differential diagnosis for small bowel intussusception.

  3. Anaesthetic Management of a patient with Myasthenia Gravis and Small Bowel Intussusception for Jejuno-Ileal Anastomoses

    Directory of Open Access Journals (Sweden)

    Pawan Kumar Jain

    2016-01-01

    Full Text Available Myasthenia gravis is a chronic autoimmune disease affecting voluntary skeletal muscles. The altered sensitivity of acetylcholine receptors to muscle relaxants and concomitant treatment with anticholinesterase in these patients affect their anaesthetic management. Patients who have undergone bowel anastomosis and are on regular anticholinesterase treatment are susceptible to anastomotic leaks. We report successful anaesthetic management of class I myasthenic patient with coexisting small bowel intussusception operated for jejuno-ileal anastomoses using regional, inhalational and intravenous (i.v anaesthesia based on train of four responses, and avoiding the use of reversal (anticholinesterase.

  4. Ileo-ileal intussusception secondary to a lipoma: a literature review.

    Science.gov (United States)

    Oyen, T L; Wolthuis, A M; Tollens, T; Aelvoet, C; Vanrijkel, J P

    2007-01-01

    Intussusception is rare in adults and it can be a challenge to diagnose on admission. Non-specific and variable signs and symptoms, frequently only occurring episodically, may cause a considerable delay before treatment. However, in 90% a predisposing organic cause can be found in adults. A case is presented of small bowel intussusception secondary to a lipoma in a 54-year-old man in whom diagnosis was suggested by CT-scan. The patient was treated with a laparoscopic-assisted reduction and extracorporeal partial small bowel resection, followed by a latero-lateral anastomosis. This case serves as the basis of a review of small bowel intussusception in adults secondary to lipomas. It focuses on the rarity of the disease, but stresses the need for early referral and investigation in middle-aged patients with recurrent abdominal symptoms.

  5. Adult Intussusception Secondary to Inflammatory Polyps

    Directory of Open Access Journals (Sweden)

    M. Faisal Jabar

    2005-01-01

    Full Text Available Adult intussusception is a rare entity that may present in the acute and subacute setting principally related to the degree of bowel obstruction. Preoperative diagnosis of this condition may be difficult. The intussusception is usually due to a definable intraluminal lesion, most probably neoplasia, unlike intussusception in children. We present the cases of two adult male patients with intussusception. The first presented with acute small-bowel obstruction secondary to a retrograde ileojejunal intussusception with a pseudopolyp as the lead point. This was possibly due to a retrograde ball-valve effect. The intussuscepting segment was resected. The second patient presented with unexplained chronic diarrhoea and an intussusception occurring within the caecum, as demonstrated at colonoscopy, with a terminal ileal pedunculated fibroid polyp as the lead point. A limited right hemicolectomy was performed. Both patients recovered uneventfully and have remained well. A brief literature review of adult intussusception complements the case reports, with an emphasis on the pathogenesis of inflammatory polyps and recommended surgical management.

  6. Microbiota-derived butyrate suppresses group 3 innate lymphoid cells in terminal ileal Peyer's patches.

    Science.gov (United States)

    Kim, Sae-Hae; Cho, Byeol-Hee; Kiyono, Hiroshi; Jang, Yong-Suk

    2017-06-21

    The regional specialization of intestinal immune cells is affected by the longitudinal heterogeneity of environmental factors. Although the distribution of group 3 innate lymphoid cells (ILC3s) is well characterized in the lamina propria, it is poorly defined in Peyer's patches (PPs) along the intestine. Given that PP ILC3s are closely associated with mucosal immune regulation, it is important to characterize the regulatory mechanism of ILC3s. Here, we found that terminal ileal PPs of specific pathogen-free (SPF) mice have fewer NKp46 + ILC3s than jejunal PPs, while there was no difference in NKp46 + ILC3 numbers between terminal ileal and jejunal PPs in antibiotics (ABX)-treated mice. We also found that butyrate levels in the terminal ileal PPs of SPF mice were higher than those in the jejunal PPs of SPF mice and terminal ileal PPs of ABX-treated mice. The reduced number of NKp46 + ILC3s in terminal ileal PPs resulted in a decrease in Csf2 expression and, in turn, resulted in reduced regulatory T cells and enhanced antigen-specific T-cell proliferation. Thus, we suggest that NKp46 + ILC3s are negatively regulated by microbiota-derived butyrate in terminal ileal PPs and the reduced ILC3 frequency is closely associated with antigen-specific immune induction in terminal ileal PPs.

  7. Emptying of the terminal ileum in intact humans. Influence of meal residue and ileal motility

    Energy Technology Data Exchange (ETDEWEB)

    Spiller, R.C.; Brown, M.L.; Phillips, S.F.

    1987-03-01

    Emptying of the terminal ileum was assessed in 15 healthy humans by injecting technetium 99m-diethyltriaminopentaacetic acid into the bowel through a multilumen orocolonic tube. The subsequent arrival of isotope in the colon was quantified by gamma-scintigraphy and colonic filling curves were obtained. Studies were performed during fasting (n = 5) cnd 2.5 h after either a low residue meal (n = 5) or a meal made high in residue (n = 5) by adding 4 g of guar. The time for 50% of the isotope to reach the colon (T50) was significantly accelerated after both meals, being 72 +/- 15 min for the high residue meal and 62 +/- 8 min for the low residue meal, compared with 183 +/- 37 min (p less than 0.01) in the 5 fasting subjects. Although the addition of guar did not alter T50 significantly, it did cause a significant fall in the rate of colonic filling, implying increased isotope dilution. Delay at the ileocolonic junction, as shown by plateaus in the middle of the colonic filling curves, was uncommon. Hold-up was significant in only 2 of 10 postprandial and 2 of 5 fasting studies. Rates of ileocolonic transit could not be related to either a mean ileal motility index or the occurrence of specific ileal motor patterns immediately proximal to the ileocolonic junction. Fasting ileocolonic transit was characteristically erratic but could not be related to interdigestive migrating motor complexes, which were rarely observed in the last 60 cm of ileum. We conclude that ileocolonic transit in humans is related to the rate at which material accumulates in the ileum, being rapid postprandially and slow and erratic during fasting. This method yields consistent results and could be used to define further factors that influence ileocolonic inflow.

  8. Small bowel intussusception in 2 adults caused by inflammatory polyps

    Directory of Open Access Journals (Sweden)

    André Carvalho, MD

    2017-12-01

    Full Text Available Inflammatory fibroid polyps are rare, benign pseudotumors of the gastrointestinal tract of unknown etiology, which may rarely present as bowel intussusception and obstruction. The authors describe the clinical, radiologic, and pathologic features of 2 patients with ileal inflammatory fibroid polyps presenting as small bowel intussusception.

  9. Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

    Directory of Open Access Journals (Sweden)

    Hiroaki Shiba

    2009-11-01

    Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

  10. Intussusception - children

    Science.gov (United States)

    ... Viral infection Englarged lymph node in the intestine Polyp or tumor The reason for the problem is more likely to be found in older children. Intussusception can affect both children and adults. However, ...

  11. The analysis of factors associated with progression of isolated terminal ileal lesions.

    Directory of Open Access Journals (Sweden)

    Zhang Fangbin

    Full Text Available To assess the factors associated with the progression of isolated terminal ileal lesions (ITILs at colonoscopy in Chinese patients.Patients diagnosed with ITILs were enrolled. The ileoscopy was performed by two experienced gastroenterologists every 52 weeks. A logistic regression analysis was used to elucidate the factors associated with Crohn's disease (CD and mucosal healing. A log rank test was used to assess the differences of the cumulative proportion of CD and mucosal healing in different groups at different times.(1 A total of 34 patients were included and no patient had taken nonsteroidal anti-inflammatory drug in the last 6 months; eight (23.5% patients had a clinical diagnosis of CD, 14 (41.2% patients achieved mucosal healing, and 12 (35.3% patients showed no significant changes in the lesions at last follow-up. (2 The logistic regression analysis showed that only abdominal pain was a factor in the ITIL disease outcomes. (3 The cumulative proportion of CD in the abdominal pain group after 3 years was statistically higher than that in the non-abdominal pain group (42.7% vs. 6.2%, χ2 = 10.129, P = 0.001. However, the cumulative proportion of mucosal healing in the non-abdominal pain group was statistically higher than that in the abdominal pain group (73.3% vs. 5.6%, χ2 = 5.225, P = 0.022. (4 The numbers of lesions observed on the initial colonoscopy exams and the initial histologic findings were not related to the ITIL disease outcomes.Clinical symptoms may be related to ITIL disease outcomes. Patients with abdominal pain had a high likelihood of CD, whereas those without abdominal pain had a high likelihood of mucosal healing.

  12. The analysis of factors associated with progression of isolated terminal ileal lesions.

    Science.gov (United States)

    Fangbin, Zhang; Weiwei, Hao; Wugan, Zhao; Cong, Zheng; Yanjun, Chu; Feng, Xu

    2014-01-01

    To assess the factors associated with the progression of isolated terminal ileal lesions (ITILs) at colonoscopy in Chinese patients. Patients diagnosed with ITILs were enrolled. The ileoscopy was performed by two experienced gastroenterologists every 52 weeks. A logistic regression analysis was used to elucidate the factors associated with Crohn's disease (CD) and mucosal healing. A log rank test was used to assess the differences of the cumulative proportion of CD and mucosal healing in different groups at different times. (1) A total of 34 patients were included and no patient had taken nonsteroidal anti-inflammatory drug in the last 6 months; eight (23.5%) patients had a clinical diagnosis of CD, 14 (41.2%) patients achieved mucosal healing, and 12 (35.3%) patients showed no significant changes in the lesions at last follow-up. (2) The logistic regression analysis showed that only abdominal pain was a factor in the ITIL disease outcomes. (3) The cumulative proportion of CD in the abdominal pain group after 3 years was statistically higher than that in the non-abdominal pain group (42.7% vs. 6.2%, χ2 = 10.129, P = 0.001). However, the cumulative proportion of mucosal healing in the non-abdominal pain group was statistically higher than that in the abdominal pain group (73.3% vs. 5.6%, χ2 = 5.225, P = 0.022). (4) The numbers of lesions observed on the initial colonoscopy exams and the initial histologic findings were not related to the ITIL disease outcomes. Clinical symptoms may be related to ITIL disease outcomes. Patients with abdominal pain had a high likelihood of CD, whereas those without abdominal pain had a high likelihood of mucosal healing.

  13. Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum

    International Nuclear Information System (INIS)

    Hoskins, W.J.; Burke, T.W.; Weiser, E.B.; Heller, P.B.; Grayson, J.; Park, R.C.

    1987-01-01

    Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland. All patients had previously undergone an abdominal operation and three patients had irradiation utilizing extended fields. In all cases, right hemicolectomy and extended ileal resection were performed with primary anastamosis of the ileum to the ascending colon or the transverse colon. Operating time averaged 4 1/2 hr utilizing hand closure anastomoses and 2 1/2 hr with stapled anastomoses. All patients received postoperative hyperalimentation and six of eight patients received preoperative hyperalimentation. One operative death occurred in a patient with intestinal perforation who required multiple resections. The remaining seven patients experienced no serious complications and had rapid return of bowel function. Our experience indicates that wide ileal resection with right hemicolectomy and primary reanastomosis is an acceptable alternative to intestinal bypass for the treatment of severe irradiation injury, especially when performed with gastrointestinal stapling devices

  14. Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum

    Energy Technology Data Exchange (ETDEWEB)

    Hoskins, W.J.; Burke, T.W.; Weiser, E.B.; Heller, P.B.; Grayson, J.; Park, R.C.

    1987-02-01

    Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland. All patients had previously undergone an abdominal operation and three patients had irradiation utilizing extended fields. In all cases, right hemicolectomy and extended ileal resection were performed with primary anastamosis of the ileum to the ascending colon or the transverse colon. Operating time averaged 4 1/2 hr utilizing hand closure anastomoses and 2 1/2 hr with stapled anastomoses. All patients received postoperative hyperalimentation and six of eight patients received preoperative hyperalimentation. One operative death occurred in a patient with intestinal perforation who required multiple resections. The remaining seven patients experienced no serious complications and had rapid return of bowel function. Our experience indicates that wide ileal resection with right hemicolectomy and primary reanastomosis is an acceptable alternative to intestinal bypass for the treatment of severe irradiation injury, especially when performed with gastrointestinal stapling devices.

  15. A case of asymptomatic ileal duplication cyst associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Hülya İpek

    2017-07-01

    Full Text Available Duplications of the alimentary tract are infrequent anomalies. They are most frequently located in the terminal ileum, and majority of them became symptomatic before the age of 2. Presenting symptoms may include abdominal mass, intestinal obstruction, intussusception, rectal bleeding, and abdominal pain. Preoperative diagnosis is usually difficult, intra-abdominal duplications are usually diagnosed during surgical explorations of above complications. We presented a 12-year-old girl with asymptomatic ileal duplication cyst associated with non-complicated acute appendicitis, whose imaging studies at admission were compatible with complicated perforated appendicitis.

  16. Prenatal Ultrasonographic Diagnosis Of Congenital Multiple Ileal ...

    African Journals Online (AJOL)

    Ileal atresia is an uncommon congenital lesion that results from intra-uterine ischemia and less commonly, from in-utero obstruction like intussusception, malrotation and internal hernia. Multiple atresias are less common and are usually diagnosed within the first 24 hours of life. The age at presentation is one to thirty days.

  17. Prolapsed ileocolic intussusception

    African Journals Online (AJOL)

    Resection and anastomosis were performed in six cases, sigmoid colostomy was performed in one case, and reduction by milking without resection was performed in three cases. All the patients recovered well. Conclusion Prolapsed intussusception is a rare presentation of intussusceptions; its diagnosis is easy but may be ...

  18. Intestinal schistosomiasis associated with intussusception: a case ...

    African Journals Online (AJOL)

    Abstract: We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7- year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound ...

  19. INTUSSUSCEPTION - A RARE ETIOLOGY

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    Mariana Branco

    2017-02-01

    Discussion / Conclusions: The clinical case described is intended to alert to the importance of investigating an underlying disease in some children and adolescents with intussusception. In this case the study led to the diagnosis of cystic fibrosis

  20. Sonographycally guided hydrostatic reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Vidmar, D.; Visnar Perovic, A.

    2004-01-01

    Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels get compressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called ''target-within-a-target'' pattern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle of normal saline was hung up 1 m over the examination desk. We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12 hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. Conclusions. Sonographically guided

  1. Jejunogastric intussusception diagnosis and management.

    Science.gov (United States)

    Wheatley, M J

    1989-08-01

    Jejunogastric intussusception is a rare complication following gastrojejunostomy, Bilroth II partial gastrectomy, and Roux-en-Y gastrojejunostomy. We report a recent patient with a retrograde gastrojejunal intussusception, the most common of the four anatomic variants of jejunogastric intussusception. It may present acutely as a surgical emergency with ischemic small bowel or chronically, with severe postprandial discomfort. Surgical correction is mandatory although controversy exists as to the most appropriate corrective procedure.

  2. Functional Disorders: Rectoanal Intussusception

    OpenAIRE

    Weiss, Eric G.; McLemore, Elisabeth C.

    2008-01-01

    Rectoanal intussusception (RI) is a telescoping of the rectal wall during defecation. RI is an easily recognizable physiologic phenomenon on defecography. The management, however, is much more controversial. Two predominant hypotheses exist regarding the etiology of RI: RI as a primary disorder, and RI as a secondary phenomenon. The diagnosis may be suspected based on clinical symptoms of obstructive defecation. Diagnostic modalities include defecography as the gold standard. Dynamic pelvic m...

  3. Cannabis intake and intussusception: an accidental association?

    Directory of Open Access Journals (Sweden)

    Alberto Fernández-Atutxa

    Full Text Available Most intussusception cases in adults have an organic cause and their treatment is surgical. In some cases, there is no injury associated with intussusception and we can opt for conservative management. In our clinical practice we have shown the presence of intussusceptions in the absence of structural damage associated with chronic cannabis with a good course after conservative management. We describe three cases of recurrent intussusception in cannabis users, suggesting a relationship between cannabis use and the incidence of intussusception.

  4. [Intussusception following renal transplantation in dogs (author's transl)].

    Science.gov (United States)

    Olsen, P R; Boserup, F; Mikkelsen, A M; Rorbech, U

    1977-01-01

    In a consecutive and non-selected study of 54 kidney transplanted dogs, 12 cases of intussusception of the small intestine developed in 8 dogs. The patogenesis is still unknown. It has been postulated that the time of the operation (4--7 hours) and the segmental termination of the post-operative atony in the intestine are essential factors in this fatal complication. The last 16 dogs in this material were peroperatively treated with antikolinergics (Mestinon NFN), which was continued until normal function of the intestine. In these dogs there were no evidence of intussusception. The value of this profylaxis is open to discussion and it is essential to solve the problem of intussusception through a "blind" and controlled trial.

  5. The imaging of intussusception

    International Nuclear Information System (INIS)

    Byrne, A.T.; Goeghegan, T.; Govender, P.; Lyburn, I.D.; Colhoun, E.; Torreggiani, W.C.

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo

  6. The imaging of intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, A.T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: angelabyrenx@hotmail.com; Goeghegan, T. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Govender, P. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Lyburn, I.D. [Department of Radiology, Frenchay Hospital, Bristol (United Kingdom); Colhoun, E. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland); Torreggiani, W.C. [Adelaide and Meath Incorporating the National Children' s Hospital, Dublin, Eire (Ireland)]. E-mail: william.torreggiani@amnch.ie

    2005-01-01

    Intussusception is defined as the telescoping of one segment of the gastrointestinal tract into an adjacent one. It is relatively common in children and is the second most common cause of an acute abdomen in this age group. It is much less common in adults and accounts for less than 5% of cases of mechanical small bowel obstruction. Whereas the diagnosis is usually already suspected in children before imaging, it is often made unexpectedly in adults. In addition, although in children there is usually no specific underlying cause, an underlying lead point is often present in adults. Plain film radiography, barium studies and ultrasound imaging play major roles in both the diagnosis and management of this condition, and it is increasingly common for the diagnosis to be made by CT and MRI, particularly in adults. This pictorial essay reviews the imaging features that may be found in patients with bowel intussusception. As well as describing the imaging features of the more commonly used tests, we also stress the role of emerging technologies such as MRI using ultrafast half-fourier sequences with single shot turbo spin echo.

  7. Intussusception of the vermiform appendix.

    Science.gov (United States)

    Dickson-Lowe, Richard A; Ibrahim, Sherine; Munthali, Lamios; Hasan, Fazal

    2015-07-16

    Appendicitis is a common presentation to an acute general surgical on call team. It can be a difficult diagnosis at times, particularly in sexually active young women, in whom it is often surgically challenging. This case is of a relatively straightforward diagnosis, taken for laparoscopic appendicectomy that resulted in performing an open right hemicolectomy for a necrotic, intussuscepted appendix. Histology ultimately revealed the cause of intussusception and resultant infarction of the appendix to be endometriosis. 2015 BMJ Publishing Group Ltd.

  8. The oro-ileal transit of cellulose.

    Science.gov (United States)

    Oyama, T; Fukuda, S; Shimoyama, T; Takahashi, I; Umeda, T; Danjo, K; Saito, D; Chinda, D; Sakamoto, J; Nakaji, S

    2008-11-01

    The effects of cellulose and the interindividual variations on the transit time in the small intestine remain unclear, but no previous study has to date taken these factors into sufficient consideration. We assessed the oro-ileal transit time and the recovery percentage of cellulose in the terminal ileum looking at interindividual variations. Seven healthy males received 100 mL of a dietary fiber-free basal diet with 5 g cellulose and 5 g of polyethylene glycol 4000. The ileal contents were aspirated every 30 min via an experimental tube placed in the terminal ileum to assess the oro-ileal transit time and the recovery percentage of cellulose. The mean percentage (with standard deviation) of the amounts of cellulose collected in the terminal ileum was 98.4%+/- 16.5% (ranging from 67.4% to 114.5%) with a coefficient variation of 16.8%. The average times (in hours) taken for 20%, 40%, 60%, and 80% of cellulose to reach the terminal ileum were 5.5 +/- 1.1, 6.7 +/- 0.7, 8.5 +/- 1.3, and 8.8 +/- 1.2, respectively, with large interindividual variations. In conclusion, the averaged recovery percentage of cellulose in the terminal ileum was approximately 100%, in accordance with the present generally accepted definition of dietary fiber. However, there were large interindividual variations in the oro-ileal transit time and the percentage of cellulose recovered.

  9. Retrograde Jejuno‑gastric Intussusception

    African Journals Online (AJOL)

    Bowel sounds were normal. Abdominal X‑ray showed dilated stomach with dilated small bowel loops ... This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be ... reduction of intussusception, but it is contraindicated when signs of peritoneal irritation are present.[9] Due to a limited view on ...

  10. [Gastroduodenal intussusception causing gastric retention.

    DEFF Research Database (Denmark)

    Alamili, M.; Berg, J.O.; Lindstrom, C.

    2008-01-01

    A case of gastroduodenal intussusception caused by a duodenal lipoma is presented. The condition was characterized by severe upper gastrointestinal retention, epigastric pain and weight loss. The mass was diagnosed by CT scan. The diagnosis was confirmed by operation. The patient was treated...

  11. Current radiological management of intussusception in children

    International Nuclear Information System (INIS)

    Ko, Hyun Soo; Schenk, Jens P.; Troeger, Jochen; Rohrschneider, Wiltrud K.

    2007-01-01

    Intussusception is the most common abdominal emergency situation in infants and small children. There has been great progress in diagnostic and therapeutic management of intussusception. Ultrasound (US) has been shown to be the first-choice imaging technique in diagnosing intussusception for reasons of high accuracy, simultaneous exclusion of differential diagnoses, and disclosure of additional pathologies. Controversial opinions exist worldwide concerning the nonoperative treatment of intussusception in infants and children. Pneumatic reduction under fluoroscopic guidance and hydrostatic reduction under US monitoring are the preferred techniques. The aim should be a success rate of at least 90% in idiopathic intussusception. This review summarizes different types of intussusception and outlines diagnostic aspects as well as several treatment concepts. (orig.)

  12. Management for intussusception in children.

    Science.gov (United States)

    Gluckman, Steven; Karpelowsky, Jonathan; Webster, Angela C; McGee, Richard G

    2017-06-01

    Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children. To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children. We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 8) in the Cochrane Library; Ovid MEDLINE (1950 to September 2016); Ovid Embase (1974 to September 2016); Science Citation Index Expanded (via Web of Science) (1900 to September 2016); and BIOSIS Previews (1969 to September 2016).We examined the reference lists of all eligible trials to identify additional studies. To locate unpublished studies, we contacted content experts, searched the World Health Organization International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov (September 2016), and explored proceedings from meetings of the British Association of Paedatric Surgeons (BAPS), the American Soceity of Pediatric Surgery, and the World Congress of Pediatric Surgery. We included all randomised controlled trials comparing contrast media, imaging modalities, pharmacological adjuvants, protocols for delayed repeat enema, and/or surgical approaches for the management of intussusception in children. We applied no language, publication date, or publication status restrictions. Two review authors independently conducted study selection and data extraction and assessed risk of bias using a standardised form. We resolved disagreements by consensus with a third review author when necessary. We reported

  13. Prolapsed ileocolic intussusception | Ibrahim | Annals of Pediatric ...

    African Journals Online (AJOL)

    Purpose This study aimed at presentingour experience with cases of prolapsed intussusception and discussing the line of treatment and the morbidity and mortality. Patients and methods Nine infants aged from 5 to 10 months were diagnosed as prolapsed intussusceptions by clinical examination. All of them were treated ...

  14. Causes and CT findings of adult intussusception

    International Nuclear Information System (INIS)

    Chun, Kyung Ah; Byun, Jae Young; Lee, Jae Mun; Ha, Hyun Kwon; Kim, Hyun; Park, Young Ha; Kim, II Sun; Kim, Jong Woo; Bahk, Yong Whee; Shinn, Kyung Sub

    1993-01-01

    Adult intussusception is a rare condition, unlike in children. There is an identifiable bowel lesion as a leading point in most of cases. Retrospectively we reviewed 22 patients with adult intussusception, and analyzed CT scans of 13 patients during the last 5 years. Twenty of the 22 patients had various causes of intussusception and 7 patients were associated with primary malignancy, 5 patients with benign tumor, and 4 patients with adhesive band. CT scans of 13 cases all showed characteristic target appearance or sausage-like soft tissue mass within the bowel, suggesting intussusception. In eleven of the 13 patients(84.6%) an intussuscepting mass was identified on CT scan as the lead point. Specific diagnosis for the cause of intussusception could be made by CT in four of 13 cases (three lipomas and one mucocele). In conclusion, CT is useful not only for the diagnosis but also for the evaluation of the leading causes of intussusception. Especially, CT could determined the exact causes of intussusception in cases of lipoma and mucocele

  15. Multiple Intussusceptions Associated with Polycythemia in an ...

    African Journals Online (AJOL)

    Intussusceptions are generally associated with mechanical lead points or localized inflammation that function as foci for intestinal telescoping. We present the case of a patient whose abuse of anabolic steroids resulted in the development of multiple simultaneous intussusceptions. Our patient had no additional identifiable ...

  16. Recurrent intussusception in children and infants

    Directory of Open Access Journals (Sweden)

    Amine Ksia

    2013-01-01

    Full Text Available Background: Recurrent intussusceptions in child and infants are problematic and there are controversies about its management. The aim of this study is to determine the details of the clinical diagnosis of recurrent intussusception and to determine the aetiology of recurrent intussusceptions. Patients and Methods: It′s a retrospective study of 28 cases of recurrent intussusception treated in the paediatric surgery department of Monastir (Tunisia between January 1998 and December 2011. Results: During the study period, 505 patients were treated for 544 episodes of intussusception; there were 39 episodes of recurrent intussusceptions in 28 patients; the rate of patients with recurrence was 5.5%. With comparison to the initial episode, clinical features were similar to the recurrent episode, except bloody stool that was absent in the recurrent group (P = 0,016. Only one patient had a pathologic local point. Conclusion: In recurrent intussusception, patients are less symptomatic and consult quickly. Systematic surgical exploration is not needed as recurrent intussusceptions are easily reduced by air or hydrostatic enema and are not associated with a high rate of pathologic leading points.

  17. Radiology residents' experience with intussusception reduction.

    Science.gov (United States)

    Bateni, Cyrus; Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L; Li, Chin-Shang

    2011-06-01

    Residents should be exposed to adequate procedural volume to act independently upon completion of training. Informal inquiry led us to question whether residents encounter enough intussusception reductions to become comfortable with the procedure. We sought to determine radiology residents' exposure to intussusception reductions, and whether their experiences vary by region or institution. U.S. radiology residency program directors were asked to encourage their residents to complete a 12-question online survey describing characteristics of their pediatric radiology department, experiences with intussusception reduction, and confidence in their own ability to perform the procedure. Six hundred sixty-four residents responded during the study period. Of those, 308 (46.4%) had not experienced an intussusception reduction, and 228 (34%) had experienced only one or two. Twenty-two percent of fourth-year residents had never experienced an intussusception reduction, and 21% had experienced only one. Among second- through fourth-year residents, only 99 (18.3%) felt confident that they could competently reduce an intussusception (P Radiology residents have limited opportunity to learn intussusception reduction and therefore lack confidence. Most think they would benefit from additional training with a computer-simulation model.

  18. Partial Ileal Bypass Undone

    NARCIS (Netherlands)

    Beynen, A.C.; Schouten, J.A.; Hoitsma, H.F.W.

    1984-01-01

    Partial ileal bypass (PIB) for the treatment of hypercholesterolaemia was introduced 20 years ago. About 110 cases have been described. We know of only 1 case of restoration of intestinal continuity; no details were given. We report here the second case of PIB in the Netherlands; the operation

  19. Anaesthetic management of intussusception in pregnancy | Nwasor ...

    African Journals Online (AJOL)

    Teamwork will win and effective communication between obstetrician, surgeon, anesthesiologist and neonatologist is obligatory. Good knowledge of the simplest and fastest anaesthetic techniques available will ensure a fruitful outcome. Keywords: anaesthesia, intussusception, obstetric patients. Annals of African Medicine ...

  20. Mantle cell lymphoma of the gastrointestinal tract presenting with multiple intussusceptions – case report and review of literature

    Directory of Open Access Journals (Sweden)

    Abo Stephen M

    2009-07-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is an aggressive type of B-cell non-Hodgkin's lymphoma that originates from small to medium sized lymphocytes located in the mantle zone of the lymph node. Extra nodal involvement is present in the majority of cases, with a peculiar tendency to invade the gastro-intestinal tract in the form of multiple lymphomatous polyposis. MCL can be accurately diagnosed with the use of the highly specific marker Cyclin D1. Few cases of mantle cell lymphoma presenting with intussuception have been reported. Here we present a rare case of multiple intussusceptions caused by mantle cell lymphoma and review the literature of this disease. Case presentation A 68-year-old male presented with pain, tenderness in the right lower abdomen, associated with nausea and non-bilious vomiting. CT scan of abdomen revealed ileo-colic intussusception. Laparoscopy confirmed multiple intussusceptions involving ileo-colic and ileo-ileal segments of gastrointestinal tract. A laparoscopically assisted right hemicolectomy and extended ileal resection was performed. Postoperative recovery was uneventful. The histology and immuno-histochemistry of the excised small and large bowel revealed mantle cell lymphoma with multiple lymphomatous polyposis and positivity to Cyclin D1 marker. The patient was successfully treated with Rituximab-CHOP chemotherapy and remains in complete remission at one-year follow-up. Conclusion This is a rare case of intestinal lymphomatous polyposis due to mantle cell lymphoma presenting with multiple small bowel intussusceptions. Our case highlights laparoscopic-assisted bowel resection as a potential and feasible option in the multi-disciplinary treatment of mantle cell lymphoma.

  1. Diagnosis and Treatment of Intussusception in Children

    Directory of Open Access Journals (Sweden)

    O.V. Spakhi

    2016-08-01

    Full Text Available Intussusception is the most common form of acquired gastrointestinal obstruction in children. The aim is to study the features of clinical course and treatment strategy for intussusception in children and to analyze limitations of diagnostic, clinical and special research methods. Materials and methods of the study. The analysis of treatment outcomes has been carried out in 272 children in pediatric surgery clinic from 2004 to 2015. We have developed the objective criteria for evaluation of intussusception stages that correlate with the degree of endotoxemia, changes in respiratory function and circulation, the disorders of gut motility, as well as ultrasound of the abdominal organs. Results and discussion. Patients with intussusception stage I (233 children had no signs of endotoxemia or they were non-significant. In 10 children we performed surgery, in 4 cases — laporoscopically. Of the 32 patients with stage II, in 8 cases the intussusception was straightened conservatively on the first try. We don’t make a second attempt in children with intussusception stage II. Surgical straightening was perfomed in 24 patients. Intussusception stage III in children (7 patients had signs of third degree endotoxemia. All patients of the third stage of intussusception underwent median laparotomy. In 5 cases we have detected intussusceptum necrosis, and these children were made bowel resection followed by the imposition of final ileostomy and intubation of the small intestine. In the rest (2 of patients, we managed to straighten the intussusceptum, and the gut was recognized as vital. Imposing primary anastomosis after the bowel resection in peritonitis we consider unacceptable. Conclusions. 1. Comprehensive survey of children using laboratory and instrumental methods became the basis for the allocation of 3 stages of intussusception, which correlated with the degree of endotoxemia and impaired bowel functions: stage I — compensated; stage II

  2. Intussusception in dogs and cats: A review of 36 cases

    OpenAIRE

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on ...

  3. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Intussusception is a known complication of Meckel's diverticulum. However, intrauterine intussusception secondary to Meckel's diverticulum has unknown incidence. Our case describes the medical and surgical management of a newborn with intrauterine intussusception of a Meckel's diverticulum as a cause of the vascular ...

  4. Pediatric radiology fellows' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Stein-Wexler, Rebecca; Bateni, Cyrus; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Intussusception reduction allows young children to avoid surgery. However, graduating residents have had relatively little training in intussusception reduction and, for the most part, consider themselves ill-prepared to perform this procedure. The goal of this study was to assess the extent of training in intussusception reduction during one year of a pediatric radiology fellowship and to determine whether graduating fellows consider themselves adequately trained in this technique. Pediatric radiology fellows were surveyed during June 2010 and asked to characterize their fellowship, to indicate the number of intussusception reductions performed (both the total number and those performed with faculty oversight but without active faculty involvement), and to assess the adequacy of their training. There were 31 responses, representing almost 1/3 of current fellows. Pediatric radiology fellows perform on average 6.9 reductions, 3.8 of which are with faculty oversight but without active faculty involvement. Ninety percent consider themselves well-trained in the technique, whereas 10% are uncertain (none consider their training inadequate). Almost all pediatric radiology fellows consider their training in intussusception reduction to be adequate. (orig.)

  5. Endometrioid Adenocarcinoma of Caecum Causing Intussusception

    Directory of Open Access Journals (Sweden)

    Rashmi Verma

    2013-01-01

    Full Text Available Malignant transformation of endometriosis is rare and is usually seen in ovarian endometriosis. The colon and rectum are the most common sites for extragonadal endometriosis, and although serosal involvement is commonly seen, mucosal involvement is rare. Malignant transformation of endometriosis is a rare but a well-known complication of endometriosis. We report an unusual presentation of endometrioid adenocarcinoma with lymph node metastasis, arising from endometriosis in the caecal wall and causing ileocaecal intussusception. The patient presented with sudden onset of abdominal pain with features suggestive of acute appendicitis. Diagnostic laparoscopy revealed an ileocaecal intussusception. Conversion to open surgery confirmed a caecal mass causing ileocaecal intussusception, and a radical right hemicolectomy was performed. Histology revealed endometrioid adenocarcinoma arising in a focus of endometriosis in the muscularis propria and involving the mucosa, with one regional metastatic lymph node.

  6. Adult Intussusception Caused by Heterotopic Pancreas

    Directory of Open Access Journals (Sweden)

    Va-Kei Kok

    2007-05-01

    Full Text Available Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.

  7. Gastrointestinal stromal tumour presenting as gastroduodenal intussusception.

    LENUS (Irish Health Repository)

    Wilson, Mark H

    2012-08-01

    Gastroduodenal intussusception secondary to gastrointestinal stromal tumour is a very rare cause for intestinal obstruction. The diagnosis of this condition can be challenging, as symptoms are often non-specific and intermittent. This article reports a case where the diagnosis was made preoperatively with abdominal imaging and was treated by a combination of endoscopic reduction and laparoscopic resection.

  8. the association of midgut malrotation with intussusception

    African Journals Online (AJOL)

    CHIRDAN

    Mini Review. Association of midgut malrotation with intussusception. L. B Chirdan and A. F Uba. Paediatric surgery unit. Department of surgery Jos University .... midline. There was no identifiable pathology at the lead point in any of them. This would strongly support the opinion of Breckon and Hadley that malrotation.

  9. Intussusception in Pregnancy - A rarely considered diagnosis ...

    African Journals Online (AJOL)

    The objective of this paper is to report a case of intussusception in a pregnant woman and to review the literature on the subject with a view to highlighting the peculiarities of this condition. The case file of a 26 year old Gravida 3, Para 0+2 lady who had appendectomy 5 years earlier and now presented at 33 weeks of ...

  10. Intestinal schistosomiasis associated with intussusception: a case ...

    African Journals Online (AJOL)

    A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of ...

  11. in diagnosis of secondary intussusception in children

    African Journals Online (AJOL)

    Ahmed Abougabal

    2014-12-02

    Dec 2, 2014 ... the most common cause of acute bowel obstruction and pain in infants. This leads to venous congestion and bowel wall edema. If intussusception is not diagnosed and treated adequately, reduced arterial blood supply, bowel infarction and perforation may follow, causing peritonitis and may even.

  12. in diagnosis of secondary intussusception in children

    African Journals Online (AJOL)

    Ahmed Abougabal

    2014-12-02

    Dec 2, 2014 ... lead points are uncommon. Lymphoma, polyps, Meckel's diverticulum and hematoma are most common identified lead points in children. Aim of the work: To assess the role of multidetector computed tomographic imaging in the diagnosis of secondary intussusception with pathological leading points in ...

  13. Intestinal intussusception due to concurrent infections with ...

    African Journals Online (AJOL)

    The rat was anorexic and depressed with rough hair coat, and died before the commencement of the experiment. Grossly, the intussusception was 7 cm in length and 27 cm caudal to the stomach and 81cm to the ileo-caecal junction. The affected part of the small intestine was moderately distended with worms and the ...

  14. Intussusception and volvulus secondary to jejunal adenocarcinoma ...

    African Journals Online (AJOL)

    ... of suspicion of malignancy in patients who present with the usual features of chronic anemia, weight loss and loss of appetite with an intra-abdominal mass. The presentation of acute intestinal obstruction, with mesenteric vein thrombosis probably due to intussusception or volvulus should not however lower the suspicion.

  15. CT manifestations of ileal dysgenesis

    Energy Technology Data Exchange (ETDEWEB)

    Oberhelman, Amy P.; Herman, Thomas E.; McAlister, William H. [St. Louis Children' s Hospital, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Department of Radiology, St. Louis, MO (United States); Keating, James P. [St. Louis Children' s Hospital, Mallinckrodt Department of Pediatrics, Washington University School of Medicine, Division of Gastroenterology, St. Louis, MO (United States); Rollins, Michael D.; Dillon, Patrick A. [St. Louis Children' s Hospital, Department of Surgery, Washington University School of Medicine, St. Louis, MO (United States)

    2007-02-15

    Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly. (orig.)

  16. Transient small-bowel intussusception in children on CT

    International Nuclear Information System (INIS)

    Strouse, Peter J.; DiPietro, Michael A.; Saez, Fermin

    2003-01-01

    To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

  17. Spontaneous reduction of intussusception: clinical spectrum, management and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kornecki, A.; Daneman, A.; Navarro, O.; Connolly, B.; Manson, D.; Alton, D.J. [Toronto Univ., ON (Canada); Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2000-01-01

    Background. To analyze the spectrum of clinical features, management and outcome of children with documented spontaneous reduction of intussusception (SROI). Materials and methods. Review of records of 50 children (33 boys, 17 girls; age range 11 days-15 years; mean age 4 years) with documented SROI, in whom intussusception was initially diagnosed by sonography (US) in 44, air enema in 2, and computed tomography in 4, in the 6-year period 1992-1998. Results. Symptoms suggestive of intussusception were present in 21 (3 of whom had Henoch-Schoenlein purpura and 4 had previous ileocolic intussusception reduced by air enema). Intussusception was an incidental finding in the other 29, in 28 of whom the finding was in the small bowel. Intussusception was limited to the small bowel in 43 and was ileocolic in 7. SROI was usually documented on US. Laparotomy performed in only 4 showed no evidence of intussusception or pathologic lead point. Outcome in all patients was favorable. Conclusions. SROI may present in symptomatic or asymptomatic children and occurs more commonly than previously reported. These intussusceptions are usually short-segment, small-bowel intussusceptions with no recognizable lead point. In asymptomatic patients, conservative observation is warranted. Intervention should be dictated by the clinical findings in symptomatic patients. (orig.)

  18. Deep sedation during pneumatic reduction of intussusception.

    Science.gov (United States)

    Ilivitzki, Anat; Shtark, Luda Glozman; Arish, Karin; Engel, Ahuva

    2012-05-01

    Pneumatic reduction of intussusception under fluoroscopic guidance is a routine procedure. The unsedated child may resist the procedure, which may lengthen its duration and increase the radiation dose. We use deep sedation during the procedure to overcome these difficulties. The purpose of this study was to summarize our experience with deep sedation during fluoroscopic reduction of intussusception and assess the added value and complication rate of deep sedation. All children with intussusception who underwent pneumatic reduction in our hospital between January 2004 and June 2011 were included in this retrospective study. Anesthetists sedated the children using propofol. The fluoroscopic studies, ultrasound (US) studies and the childrens' charts were reviewed. One hundred thirty-one attempted reductions were performed in 119 children, of which 121 (92%) were successful and 10 (8%) failed. Two perforations (1.5%) occurred during attempted reduction. Average fluoroscopic time was 1.5 minutes. No complication to sedation was recorded. Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high,raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation.

  19. BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

    Science.gov (United States)

    Denenholz, Edward J.; Feher, George. S.

    1955-01-01

    Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

  20. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs

    OpenAIRE

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-01-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  1. Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs.

    Science.gov (United States)

    Atray, Mandeep; Raghunath, Mulinti; Singh, Tarunbir; Saini, Narinder Singh

    2012-08-01

    The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.

  2. A case of compound intussusceptions in a Nigerian child – a rare ...

    African Journals Online (AJOL)

    Intussusception is the most common, non-congenital, cause of intestinal obstruction in infants. There are various patterns of intussusception seen in children with the most common being ileo-colic variety. Compound intussusception in which intussusception involves more than one non-adjacent segment is a rare finding in ...

  3. Pediatric intussusception in a Saudi Arabian tertiary hospital

    African Journals Online (AJOL)

    Karp, James E. Allen and Theodore C. Jewett, Jr. Intussusception: Evolution of Current Management. J Pediatric. Gastroenterol Nutr, Vol 6 No 5, 1987. 1 1. Ajao O G. Non-infantile intussusception J. Natl Med Assoc. 1979; 71: 65 -67. 12. Mackay A J . Mackellar A and Sprague P. lntussuseeption in. '\\ Children: A review of 91 ...

  4. Delayed presentation of intussusception in children–a surgical audit

    African Journals Online (AJOL)

    473–480. 2 Kaiser AD, Applegate KE, Ladd AP. Current success in the treatment of intussusception in children. Surgery 2007; 142:469–477. 3 Herwig K, Brenkert T, Losek JD. Enema-reduced intussusception management: is hospitalization ...

  5. Delayed presentation of intussusception in children–a surgical audit ...

    African Journals Online (AJOL)

    Background The preferred modality of treatment of intussusception is radiologic reduction; however, the situation is different in our setup, in which surgery is the only possible treatment modality to salvage patients. This study presents the management of patients of intussusception in our setup with delayed presentation, ...

  6. Adult intussusception due to intestinal tuberculosis: a rare entity ...

    African Journals Online (AJOL)

    Intussusception is a rare occurrence in adults in comparison with the children. A demonstrable aetiology is found in most cases of adult intussusception. Abdominal tuberculosis (TB) is common in developing countries especially in South Africa in the era of HIV/ AIDS, and many of them present with surgical abdomens ...

  7. Prolapsed intussusception in children: a report of 4 cases | Ngom ...

    African Journals Online (AJOL)

    Background: Prolapsed intussusception is defined the invagination of an intestinal segment into the adjacent segment to it, with exteriorization of the head intussusception through the anus. Patients and Methods: Four children were diagnosed in the Emergency Unit of “Hôpital Aristide Le Dantec” of Dakar. Results: The ...

  8. The second trial pneumatic reduction for idiopathic intussusception ...

    African Journals Online (AJOL)

    Purpose To study the therapeutic effect of the second trial pneumatic reduction on patients with idiopathic intussusception. Patients and methods A prospective study was carried out on patients with idiopathic intussusception presenting to our unit, between August 2009 and January 2010. We excluded patients older than 2 ...

  9. Colo-colic intussusception associated with pneumatosis cystoides intestinalis

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, O.; Daneman, A.; Alton, D.J. [Department of Diagnostic Imaging, Hospital for Sick Children and the University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada); Thorner, P. [The Division of Pathology, Hospital for Sick Children and the University of Toronto, Toronto (Canada)

    1998-07-01

    This paper describes pneumatosis cystoides intestinalis in association with colo-colic intussusception in a young teenager. The intussusception was easily reduced at barium enema. The recognition of the characteristic filling defects in the barium column facilitates a correct diagnosis. This association has only been reported previously in six adults. (orig.) With 2 figs., 9 refs.

  10. a case of compound intussusceptions in a nigerian child

    African Journals Online (AJOL)

    is a major contributor to morbidity and mortality in the treatment of intestinal obstruction. We report the first documented case of double compound intussusception in an. African child and reviewed relevant literature. Keywords: Antegrade and retrograde; Children; Compound; Intussusception. Annals of Ibadan Postgraduate ...

  11. Colo-colic intussusception associated with pneumatosis cystoides intestinalis

    International Nuclear Information System (INIS)

    Navarro, O.; Daneman, A.; Alton, D.J.; Thorner, P.

    1998-01-01

    This paper describes pneumatosis cystoides intestinalis in association with colo-colic intussusception in a young teenager. The intussusception was easily reduced at barium enema. The recognition of the characteristic filling defects in the barium column facilitates a correct diagnosis. This association has only been reported previously in six adults. (orig.)

  12. Case of colonic intussusception secondary to mobile cecum syndrome repaired by laparoscopic cecopexy using a barbed wound suture device.

    Science.gov (United States)

    Yamamoto, Tetsu; Tajima, Yoshitsugu; Hyakudomi, Ryoji; Hirayama, Takanori; Taniura, Takahito; Ishitobi, Kazunari; Hirahara, Noriyuki

    2017-09-21

    A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum (i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.

  13. Chronic intussusception in children caused by Ascaris lumbricoides.

    Science.gov (United States)

    Nikolić, Harry; Palčevski, Goran; Saina, Giordano; Peršić, Mladen

    2011-05-01

    Chronic intussusception (CI) is defined as an intussusception lasting for 14 days or more. Because the clinical manifestations are non-specific, the diagnosis is usually delayed. Symptoms include intermittent abdominal pain, sometimes an abdominal mass is palpable and there is a marked weight loss. Diagnosis is based on typical features revealed by ultrasound or barium enema and CT investigations. Therapy is surgical with obligatory exclusion of possible underlying lesions. We report a case of a 3.5-year-old girl with chronic intussusception. Laboratory blood findings revealed sideropenic anemia and stools positive for Ascaris lumbricoides. Anti-parasitic therapy with mebendazole was repeatedly administered with early improvements but soon after symptoms relapsed. During surgery an ileocolic chronic intussusception extending to hepatic flexure was found. Postoperative control examinations proved complete healing. We suspected that Ascaris lumbricoides infestation was an etiologic factor for the development of chronic intussusception in the child.

  14. Intussusception. Part 1: A review of diagnostic approaches

    Energy Technology Data Exchange (ETDEWEB)

    Daneman, Alan; Navarro, Oscar [Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8 (Canada)

    2003-02-01

    The vast majority of symptomatic intussusceptions in children arise in the ileum and are either ileocolic or ileoileocolic. The clinical diagnosis of these ''idiopathic'' intussusceptions may be difficult to make. Failure to make a prompt diagnosis and initiate appropriate treatment may lead to bowel ischemia, perforation, peritonitis, shock and even death. The clinician, therefore, may have to rely on imaging procedures to diagnose or exclude the presence of intussusception promptly and accurately. The imaging diagnosis of intussusception can be made with sonography or plain abdominal radiographs or by contrast (including air) enema examinations of the colon. This article highlights the current concepts and some controversial issues related to the imaging diagnosis of intussusception. (orig.)

  15. Ultrasonographic findings of intestinal intussusception in seven cats.

    Science.gov (United States)

    Patsikas, M N; Papazoglou, L G; Papaioannou, N G; Savvas, I; Kazakos, G M; Dessiris, A K

    2003-12-01

    The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a 'kidney' configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.

  16. An incidentaloma at ileal intubation.

    LENUS (Irish Health Repository)

    Donnellan, Fergal

    2012-02-01

    The authors report the case of a primary small bowel lymphoma discovered incidentally in a 33-year-old male following ileal intubation at colonoscopy. The patient subsequently underwent curative treatment with chemotherapy. This case not only highlights the importance of routine ileoscopy but also the successful use of chemotherapy in a disease for which the optimal treatment modality has not been well characterized.

  17. Intussusception in children: not only surgical treatment

    Directory of Open Access Journals (Sweden)

    Anna Maria Caruso

    2017-02-01

    Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

  18. Intussusception in dogs and cats: A review of 36 cases

    Science.gov (United States)

    Levitt, Lyndell; Bauer, Michael S.

    1992-01-01

    Intussusception is recognized as a common cause of bowel obstruction in small animals. This study documents the clinical and surgical findings in nine cats and 27 dogs diagnosed as having intussusception. The main purposes of the study were to define the predisposing causes and clinical signs of intussusception and to evaluate various surgical techniques commonly employed in its treatment. No common predisposing cause could be established. Diagnosis of intussusception was based most often on clinical signs of bowel obstruction in association with the palpable abdominal mass. The majority of the intussusceptions involved the enterocolic junction. Formation of adhesions was more frequent in cats. Surgical treatments included simple reduction, manual reduction with plication, intestinal resection/anastomosis, and intestinal resection/anastamosis with plication. There was no statistically significant difference (p>0.05) in the recurrence rate of the intussusceptions when the various surgical techniques were compared. Recurrence of an intussusception was not related to either the bowel segment involved or whether a simple reduction, bowel resection, or intestinal plication was performed at the initial surgery. PMID:17424091

  19. Pylorogastric intussusception in a Chihuahua puppy. A case report.

    Science.gov (United States)

    Lideo, L; Mutinelli, F; Milan, R

    2010-12-01

    A three-month-old Chihuahua dog was presented with acute abdominal pain, vomiting and cardiovascular shock. Abdominal ultrasound (US) and iodated contrast gastrogram revealed suspected pylorogastric intussusception. Because of the poor prognosis the dog was euthanatized. Diagnosis of pylorogastric intussusception was confirmed at necropsy. Parasitological, virological, serological and histological examinations were also performed. This report documents the sixth case of pylorogastric (i.e. duodenogastric, gastrogastric) intussusception in the veterinary medical literature and it is the first report on a puppy dog in which US and radiographic diagnosis were confirmed post mortem.

  20. Jejunojejunal Intussusception Induced by Lipomatous Polyp of Jejunum

    Directory of Open Access Journals (Sweden)

    Jayant Kumar Biswal

    2017-10-01

    Full Text Available Adult intussusception is rare unlike childhood variety where it is the leading cause of intestinal obstruction. Preoperative diagnosis is often difficult as the symptoms are nonspecific and so high index of suspicion is needed for early diagnosis by appropriate investigations. This is a case of 65-year-old man presented with acute intestinal obstruction whose laparotomy revealed a jejunojejunal intussusception secondary to a lipomatous lesion which was successfully treated with resection and primary anastomosis. When dealing with a case of chronic intermittent intestinal obstruction, intussusception must be kept in mind as one of the differential diagnosis.

  1. Adult ileocolic intussusception secondary to ileocaecal valve polyp.

    LENUS (Irish Health Repository)

    Chugthai, Saqib Zeeshan

    2012-01-31

    Intussusception is relatively common in children, but it is a rare cause of abdominal pain and intestinal obstruction in adults. The aetiology, clinical presentation and management of this condition differs in adults and children. Preoperative clinical diagnosis is usually difficult due to the non-specific and intermittent nature of the symptoms. Ultrasound and computed tomography can be helpful in establishing the diagnosis. We present a case of adult ileocolic intussusception with classical radiological signs and operative findings. In adults the diagnosis of intussusception should be considered in a case of intermittent abdominal pain, especially with clinical signs of intermittent bowel obstruction.

  2. [Torsion of the vermiform appendix associated with intussusception].

    Science.gov (United States)

    Baeza-Herrera, Carlos; García-Cabello, Luis Manuel; León-Cruz, Alberto; Martínez-Rivera, María de Lourdes

    2006-01-01

    Vermiform appendix torsion is a rare condition, with only 25 cases recorded in the international literature. Our patient is the first case associated with intussusception. A 2-month-old female infant suddenly developed severe abdominal pain due to ileoceal intussusception. During surgical exploration, a tight intussusception was reduced. Three days later, a new laparotomy was required and we found torsion and perforation of the vermiform appendix. The patient underwent appendectomy, but there was dehiscence of the appendiceal stump and cecal perforation requiring a new surgical exploration. The patient had an uneventful recovery.

  3. Ultrasound guided reduction of childhood intussusception

    International Nuclear Information System (INIS)

    Yoon, Chong Hyun; Kim, Han Suk

    1986-01-01

    Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasound guidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates of saline enema under ultrasound guidance during a first-8 month period (P1) and a second-10 month period (P2) were 55.6% (5/9) and 54.5% (6/11) respectively. Average success rate was 55% (11/20). 2. During the periods of P1 and P2, no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful reduction with saline enema were confirmed by clinical follow-up without barium enema. 4. During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 cases of segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. No radiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, this method could completely replace barium enema. And ultrasonography should be the initial study in the evaluation of intussusception in children and then if necessary, saline enema under ultrasound guidance should be done.

  4. Spontaneous ileal perforation complicating low anorectal malformation

    Directory of Open Access Journals (Sweden)

    TiJesuni Olatunji

    2015-01-01

    Full Text Available Anorectal malformation is a common anomaly in neonates. Although colorectal perforations have been reported as a complication, ileal perforation is rarely encountered. This is a report of a 2-day-old boy presenting with a low anorectal malformation, complicated with ileal perforation, necessitating laparotomy and ileal repair. Anoplasty was done for the low anomaly. Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication.

  5. Evaluating Pediatric Intussusception Using 24-hour Ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-Jung Chang

    2013-08-01

    Conclusion: Radiographic imaging at night results in higher radiation exposure and negative enema findings. Twenty-four-hour ultrasound availability would decrease the radiation exposure and unnecessary enemas for intussusceptions suspected clinically.

  6. Meckel's diverticulum: the lead point of intrauterine intussusception ...

    African Journals Online (AJOL)

    Meckel's diverticulum: the lead point of intrauterine intussusception with subsequent intestinal atresia in a newborn. Viet H. Le, Paul A. Perry, Allyson L. Hale, Robert L. Gates, John C. Chandler ...

  7. Gut luminal endogenous protein: implications for the determination of ileal amino acid digestibility in humans.

    Science.gov (United States)

    Moughan, Paul J; Rutherfurd, Shane M

    2012-08-01

    The true ileal digestibility assay provides the most informative measure of digestibility to assess bioavailability of amino acids in foods for humans. To determine 'true' estimates of ileal amino acid digestibility, requires that endogenous amino acids present in digesta at the terminal ileum be quantified. The amounts of endogenous amino acids in ileal digesta can be determined after feeding an animal or human a protein-free diet (traditional approach) or by various methods after giving a protein-containing diet. When the protein-free method has been applied with adult human subjects an overall mean value (three separate studies) for endogenous ileal nitrogen flow of 800 mg N/d has been reported. This value is considerably lower than a comparable value obtained after feeding protein of 1852 mg N/d (mean of four separate studies), and thus endogenous ileal N and amino acids should be measured under conditions of protein alimentation. There is some confusion concerning the terminology used to define digestibility, with the term "true" digestibility having different adopted meanings. Here, true amino acid digestibility is defined as apparent amino acid digestibility corrected for the basal amino acid losses determined after giving either a protein-free or a protein-containing diet. Basal losses should be determined at a defined dry-matter and protein intake. The protein-free diet approach to determining endogenous amino acids is considered unphysiological and basal losses refer to ileal endogenous amino acid flows associated with digesta dry-matter flow, and not including "specific" effects of dietary factors such as non starch polysaccharides and anti nutritional factors. Arguments are advanced that the enzyme hydrolysed protein/ultra filtration method may be suitable for routine application with a cannulated pig model, to obtain physiologically-valid basal estimates of ileal endogenous amino acids to allow calculation of true ileal amino acid digestibility in the

  8. Recurrent intussusception, coeliac disease and cholelithiasis: A unique combination

    Directory of Open Access Journals (Sweden)

    Sinha C

    2007-01-01

    Full Text Available Authors report an 11-month-old female child, who presented with recurrent episodes of colicky abdominal pain and diarrhea. An abdominal ultrasound revealed small bowel intussusception. She was also noted to have a thick walled gall bladder and a solitary gallstone. Further investigations confirmed the diagnosis of coeliac disease. The combination of small bowel intussusception, coeliac disease and cholelithiasis is unique and has not been reported in the literature.

  9. Colorectal intussusception: an unusual gastrointestinal complication of hereditary angioedema.

    Science.gov (United States)

    Witschi, A; Krähenbühl, L; Frei, E; Saltzman, J; Späth, P J; Müller, U R

    1996-09-01

    A 21-year-old man with a history of hereditary angioedema presented with protracted abdominal pain which failed to respond to infusion of C1 inhibitor concentrate. Evaluation by CT scan revealed extensive colorectal intussusception requiring surgical intervention. Under replacement therapy with C1 inhibitor concentrate, both the operation under general anesthesia and the postoperative phase were uneventful. The intraoperative examination suggested initiation of intussusception by local mucosal edema in the transverse colon.

  10. Acute jejunogastric intussusception: a rare cause of abdominal pain.

    Science.gov (United States)

    O'Dell, K B; Gordon, R S; Victory, C

    1992-05-01

    We report the case of a 61-year-old man with a history of a Bilroth II procedure who presented to the emergency department after 12 hours of severe epigastric pain and one episode of coffee-ground emesis. Computed tomography and esophagogastroduodenoscopy revealed intussuscepted jejunum through a gastrojejunostomy that required emergency operative reduction. This case illustrates the rare complication of acute jejunogastric intussusception more than 20 years after a Bilroth II procedure.

  11. [Contribution of imaging in intestinal intussusception in the adult. Apropos of a case of ileocolic intussusception secondary to cecal lipoma].

    Science.gov (United States)

    Farrokh, D; Saadaoui, H; Hainaux, B

    1996-01-01

    On the basis of a case of ileocolonic intussusception in a 35-year-old patient secondary to an obstructive lipoma of the caecum, the authors review the literature and discuss the clinical and radiological aspects of this disease. The diagnosis was established by CT scan and barium enema before surgery. Adult intussusception is a rare disease, which does not have any specific clinical features. Radiological imaging is the only complementary investigation which can suggest the diagnosis.

  12. Time requirement for barium reduction in intussusception

    International Nuclear Information System (INIS)

    Hwang, Hye Eun; Kim, Seung Ho; Kang, In Young; Park, Byoung Lan; Kim, Byoung Geun

    1988-01-01

    During the period between January 1985 and December 1987, barium reduction was performed in 146 cases of intussusception who were admitted to Kwangju Christian Hospital. The results were as follows: 1. Success rate to the symptom duration is relatively constant. 2. The success rate in infants with severe dehydration was 50% but it was gradually increased in infants with moderate dehydration and in infants with mild dehydration, 83.3% and 100% respectively. 3. The success rate of 12 cases in severely dehydrated infants with positive dissection sign was 16.7%. 4. The success rate of 15 cases in moderately dehydrated infants with positive dissection sign was 66.7%. 5. The average time requirement for barium reduction was 58.3 minutes. No serious complications were noted during barium reduction, except mild vomiting. 6. With above results, it is desirable that barium reduction should be performed according to the patient's physical status and radiologic findings.

  13. Prolapse of Intussusception through the Anus as a Result of Sigmoid Colon Cancer

    Directory of Open Access Journals (Sweden)

    Hiroki Ochiai

    2010-09-01

    Full Text Available Adult intussusception is rare and most often associated with cancer. We report a case of intussuscepted sigmoid colon into the rectum protruding from the anus of a 47-year-old woman. The cause of the intussusception was sigmoid colon cancer. We removed the intussuscepted part of the sigmoid colon as well as the rectum and regional lymph nodes. The patient recovered uneventfully and there has been no evidence of recurrence of the cancer.

  14. Non-Hodgkin's lymphoma revealed by an ilio-colic intussusception ...

    African Journals Online (AJOL)

    Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma's involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent ...

  15. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  16. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    International Nuclear Information System (INIS)

    Jeong, Jewon; Hong, Seong Sook; Hwang, Ji Young; Kim, Hyun Joo; Chang, Yun Woo

    2015-01-01

    We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  17. Acute diverticulitis of the terminal ileum: ultrasonography and CT findings

    Directory of Open Access Journals (Sweden)

    Jewon Jeong

    2015-01-01

    Full Text Available We describe a rare case of terminal ileal diverticulitis in a 68-year-old female with a day of history Epub ahead of print of right lower quadrant pain and tenderness, mimicking acute appendicitis. Ultrasonography revealed small sac-like out-pouching lesions with increased echogenicity of surrounding fat in thickened terminal ileum, suggesting inflamed diverticula. We diagnosed terminal ileal diverticulitis primarily by ultrasonography. The diagnosis was confirmed by subsequent computed tomography.

  18. Mini-laparoscopic reduction of intussusception for children.

    Science.gov (United States)

    Lai, I R; Huang, M T; Lee, W J

    2000-06-01

    The success of mini-laparoscopic cholecystectomy and splenectomy has encouraged the application of this new technique in children with non-complicated intussusception. Here, we report on the use of this technique in two children, aged 21 and 24 months, respectively, who had failed saline enema reduction of ileocolic intussusception. Under a 2-mm videoscopic visualization, the intussuscepted bowel was identified and reduced with the assistance of a 2-mm working port placed at the right lower abdominal area and a 5- to 10-mm working port placed at the supraumbilical area. An intussuscepted lymph node at the ileocecal area, as the lead point, was removed at the time of the procedure in one child. Both patients experienced relief of symptoms the day after operation and resumed a regular diet on the first post-operative day. No recurrence or complications, including abscess and wound infection, occurred. These findings suggest that mini-laparoscopic reduction is a safe procedure for children with uncomplicated intussusception. Moreover, the procedure provides better cosmesis than conventional laparoscopic techniques.

  19. Intussusception Caused by Yersinia enterocolitica Enterocolitis in a Patient with Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    Geetanjali Gupta

    2010-01-01

    Full Text Available Yersinia enterocolitica intussusception is rarely encountered in patients without an underlying susceptibility and is most frequently reported in iron-overloaded patients. This is thought to be related to the unusual use of iron by this microorganism. We present a case of a 5-year old child with intussusception of the terminal ileum caused by Y. enterocolitica whose past medical history was significant for sickle cell disease. This type of presentation is extremely rare. His monthly blood transfusions may have put him at risk for Y. enterocolitica enterocolitis. The pathogenesis of this disease relates to the role of iron as an essential growth factor for Y. enterocolitica , and this patient's transfusions left him in an iron overloaded state despite treatment with Deferoxamine. Our patient's unusual presentation of intusssuception was secondary to the mass effect caused by lymphoid hyperplasia, specifically hypertrophied Peyer's patches in the ileum caused by the Y. enterocolitica infection. We believe that our case demonstrates that Y. enterocolitica should be considered a possible pathogen in patients with sickle cell disease, especially if symptoms occur shortly after blood transfusion.

  20. Successful Endoscopic Repair of Postoperative Ileocecal Intussusception in An Adult

    Directory of Open Access Journals (Sweden)

    Manabu Shiraishi

    2013-06-01

    Full Text Available Postoperative ileocecal intussusception is a rare complication in adult patients with abdominal aortic repair. A 63-year-old male patient with an abdominal aortic aneurysm was admitted to our hospital for abdominal aortic replacement. On the third postoperative day, he had nausea, vomiting, and distention. An abdominal x-ray showed air-fluid levels. His condition improved after 72 h of conservative treatment with long-tube suction for decompression. On the sixth postoperative day, he had acute abdominal pain. A computed tomography scan showed the typical intussusception picture. A diagnostic and therapeutic endoscopy were performed. An ileocecal intussusception 20 cm proximal to the ileocecal valve was found and endoscopically reduced. [Arch Clin Exp Surg 2013; 2(3.000: 204-206

  1. [Yersinia enterocolitica: a cause of acute intestinal intussusception].

    Science.gov (United States)

    Barthod, F; Gayet, P; Parlier, H; Turner, L; Barre, O; Farah, A; Patel, J C

    1996-04-20

    Yersinia enterocolitica infection is a rare cause of intestinal intussusception, especially in adults. We report here a case in a 29-year-old man and review the literature on diagnosis and therapy. A 29-year-old man presented with a 2-week history of diarrhea and weight loss. Ultrasonography revealed acute intestinal intussusception localized at the site of enlarged mesenteric nodes. At laparostomy, intestinal resection was not required. Histology examination of the mesenteric nodes showed follicular hyperplasia. Serology was positive for Yersinia enterocolitica. Outcome was favorable after treatment with tetracycline for 15 days. Yersinia enterocolitica are Gram negative bacilli that grow at low temperature. Food contamination is the most frequent source of infection in man, usually in children. Clinical manifestations include gastroenteritis or pseudoappendicular syndrome. Intestinal intussusception is rare. Operative reduction by taxis is generally sufficient. Histology examination of the lymph nodes excludes lymphoma. The diagnosis is confirmed by serology. A 10 to 15-day antibiotic regimen is needed.

  2. US features of transient small bowel intussusception in pediatric patients

    International Nuclear Information System (INIS)

    Kim, Ji Hye

    2004-01-01

    To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5 ± 0.3 cm) diameters and with thin (mean, 3.5 ± 1 mm) outer rims along the course of the small bowel. The mean length was 1.8 ± 0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n 2). All patients discharged with improved condition. Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration

  3. Juvenile polyposis syndrome presenting as intussusception in a ...

    African Journals Online (AJOL)

    We report a rare case of juvenile polyposis syndrome (JPS) in a 5 year old girl who was admitted into the emergency room on account of acute intestinal obstruction secondary to ileo-colic intussusception. Prior to the admission, she has had repeated blood transfusion in the referring hospital following anaemia due to long ...

  4. Routine surgical intervention for childhood intussusception in a ...

    African Journals Online (AJOL)

    and inflamed Peyer's patches were noted in 37 (52.1%), and polyp in 3 (4.2%). Manual ... Conclusion: Intussusception in our setting is characterized by late presentation, high rate of bowel resection, and ... des lacunes dans le temps pour le diagnostic, les installations spécialisées et les membres du personnel améliorer.

  5. Seasonality and surgical management of intussusception over 10 ...

    African Journals Online (AJOL)

    47.5%of patients had resection and primary anastomosis while 24.0% had manual reduction at laparotomy. Conclusion: Intussusception is one of the most common paediatric surgical emergencies at Harare Central Hospital. The age and sex of patients are the same as those found in literature. In contrast with previous data ...

  6. Acute intussusception in children seen at El Obeid Hospital, Western ...

    African Journals Online (AJOL)

    54.2% of cases had resection and anastomosis for bowel ischaemia, while in 45.8% manual reduction was done. The post-operative mortality was 16.7%. Conclusions: Childhood intussusception was common in male infants from rural areas in the dry season. Late presentation to the surgeon necessitated major operative ...

  7. Jejuno-jejunal intussusception secondary to smallbowel lipomatosis ...

    African Journals Online (AJOL)

    Intussusception is usually a disease of children aged between 6 months and 4 years, in which a part of a bowel telescopes into another part of the bowel. We report a case in a 60-year-old man who required resection and anastomosis. Although intussception is unusual in adults, awareness of the differences in symptoms ...

  8. Case Report - Intussusception caused by an inverted Meckel's ...

    African Journals Online (AJOL)

    The intra operative findings were distention of the small bowel and intussusception of ileus due to an inverted Meckel's diverticulum located 70 cm from the ileocecal valve. 30 cm ischemic loop was identified. A segmental small bowel resection and hand-sewn anastomosis was performed. Histopathology distinguished ...

  9. Endoscopic Diagnosis of Jejuno-Gastric Intussusception | Mwachiro ...

    African Journals Online (AJOL)

    Jejunogastric intussusception is a rare complication of gastric surgery that is potentially life threatening if it is not diagnosed early. This condition is a surgical emergency and is most commonly seen after gastro-jejunostomy. The authors report a case of an elderly female patient who presented with hematemesis and ...

  10. Pneumatic reduction of intussusception in children at Korle Bu ...

    African Journals Online (AJOL)

    Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great ...

  11. Adult intussusception: An unlikely diagnosis | Nicolaou | SA Journal ...

    African Journals Online (AJOL)

    ... and it allows prompt surgical management to avoid severe complications, particularly bowel ischaemia and necrosis. This case report describes the clinical and multimodality radiological findings of an ileocolic intussusception secondary to a mucosa-associated lymphoid tissue (MALT) lymphoma in a young adult patient.

  12. The second trial pneumatic reduction for idiopathic intussusception ...

    African Journals Online (AJOL)

    Annals of Pediatric Surgery 2012, 8:77–79. Keywords: intussusception, pneumatic reduction, radiation dose. aPediatric Surgery Unit and bDepartment of Diagnostic Radiology and Medical. Imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Correspondence to Amr Abdelhamid AbouZeid, MD, Pediatric ...

  13. Chronic Ileocecal Intussusception Secondary to Non-Hodgkins ...

    African Journals Online (AJOL)

    Chronic intussusception is a distinct clinical entity which is unfortunately poorly recognized due to its atypical presentation. A 5½ year old female patient presented with a 5 month history of abdominal pain associated with occasional vomiting, anorexia and progressive weight loss. 5 days prior to admission she developed ...

  14. Hydrostatic reduction of intussusception with normal saline using the ...

    African Journals Online (AJOL)

    Hydrostatic reduction of intussusception with normal saline using the gravity aided method in a Nigerian teaching hospital. M.A. Abdulsalam, B.O. Balogun, R.I. Osuoji, O.O. Olofinlade, O.M. Faboya, M.A. Bankole ...

  15. Intussusception after Laparoscopic Gastric Bypass Surgery: An Underrecognized Complication

    Directory of Open Access Journals (Sweden)

    Smit Singla

    2012-01-01

    Full Text Available Introduction. Intussusception after bariatric surgery is an uncommon complication that is now being frequently reported. Most people consider dysmotility to be the causative mechanism in the absence of obvious etiology. Material and Methods. A worldwide search identified literature describing intussusception after bariatric surgery. We also included our own patients and analyzed information regarding demographic profile, risk factors, presentation, diagnosis, and post treatment course. Results. Seventy one patients were identified between 1991 and 2011. Majority of the affected patients were females (=70, 98.6%; median time to presentation after gastric bypass surgery was 36 months. Most patients presented with abdominal pain, nausea and vomiting, but without obvious peritonitis. Sixty eight patients (96% required surgery; 48 (70.6% underwent revision of anastomosis, 16 (23.5% had reduction without resection, while 4 patients (5.9% had plication only. Amongst these, most patients (=51, 75% were found to have retrograde intussusception. Post-operatively, 9 patients presented with recurrence (range, 0.5–32 months. Five patients, who had earlier been treated without resection, eventually required revision of the anastomosis. There was no mortality noted. Conclusion. Intussusception after bariatric surgery is uncommon and its diagnosis is based on a combination of physicial, radiological and operative findings. An early surgical intervention reduces morbidity and prevents recurrence.

  16. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa. ... reduction outcomes were not comparable to international standards. The only statistically significant predictor of poor outcome of AIR was time delay before attempted reduction.

  17. Intussusception in children seen at Muhimbili National Hospital, Dar ...

    African Journals Online (AJOL)

    Objective: To review infants and children with intussusception and assess its magnitude of concern and any seasonal variation in our environment. Design: A retrospective study. Setting: Muhimbili National Hospital general paediatric and surgical wards from January 2000 to February 2004. Methodology: The charts of all ...

  18. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  19. Intussusception caused by dried apricot: A case report

    Directory of Open Access Journals (Sweden)

    Yana Puckett

    2014-01-01

    CONCLUSION: Bezoars are an extremely rare cause of intussusception in adults. A high level of suspicion needs to exist in the presence of a history of eating dried fruit, history of gastric surgery, diabetes mellitus, and problems with mastication. Various treatment modalities exist to treat obstructions secondary to bezoars, including open reduction and removal of bezoar via enterotomy.

  20. Retrograde pylorogastric intussusception – Case report and review

    Directory of Open Access Journals (Sweden)

    Efrat Avinadav

    2016-07-01

    Full Text Available A case of gastric outlet obstruction in an infant due to retrograde intussusception of the pylorus into the stomach is presented. This anomaly is extremely rare, with almost no reports in the literature. The patient underwent formal Heineke-Mikulicz pyloroplasty with an uneventful recovery and resumed full enteral feeding.

  1. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    Retrograde jejunal intussusception is a rare disease. A 60‑year‑old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs‑en‑Y. On examination, there was a palpable wax‑like mass on the left‑hand side underneath the umbilicus. Computerized ...

  2. Retrograde jejunal intussusception after total gastrectomy: A case ...

    African Journals Online (AJOL)

    2015-11-02

    Nov 2, 2015 ... Retrograde jejunal intussusception is a rare disease. A 60-year-old female patient was hospitalized due to vomiting for 2 days, with a history of radical gastrectomy plus esophagus jejunum Rouxs-en-Y. On examination, there was a palpable wax-like mass on the left-hand side underneath the umbilicus.

  3. An audit of paediatric intussusception radiological reduction at the ...

    African Journals Online (AJOL)

    summarised in Table 1; 28 of the patients (80.0%) were 12 months old or younger. ... consecutive attempts of stepwise increased pneumatic pressure at. 80, 100 ... Table 2. Duration and type of symptoms among children diagnosed with intussusception (N=35) n. %. Duration of symptoms (hours). 24 - 48. 5. 14.7.

  4. Chemical composition and standardized ileal digestibility of protein and amino acids from blue mussel, starfish, and fish silage in pigs

    DEFF Research Database (Denmark)

    Nørgaard, Jens Vinther; Petersen, Jens Kjerulf; Tørring, Ditte Bruunshøj

    2015-01-01

    fish silage from farmed salmon was also included in theexperiment. The standardized ileal digestibility (SID) of crude protein (CP) and amino acids(AA) was evaluated in a Latin square design with pigs (initial weight 39.3 kg) fitted with asimple T-cannula in the terminal ileum. Diets contained 131...

  5. Structural changes in intestinal enteroendocrine cells after ileal interposition in normal rats

    OpenAIRE

    Gilmara S. Aguiar-Yamaguchi; João-Luiz M. C. Azevedo; Marcelo C. Carlini; Paolo H. B. Lourenco; Wellington Cardia; Maria T. S. Alves; Aparecida E. Hirata; Lucas P. F. F. Leal; Bianca Marigliani; Linda O. A. Bernardes; Karina F. Neves; Rudy N. Rocha; José-Francisco Borborema; João-Luiz C. Azevedo; Otavio C. Azevedo

    2011-01-01

    INTRODUCTION: No therapeutic approach has significantly impacted the progression of diabetes. As early improvement of glicaemic control is observed after bariatric surgeries, there is currently a search for surgical procedures that can promote euglycemia also in non-obese patients. Glicaemic control can be achieved by increasing the blood concentration of GLP-1, a hormone produced by L cells that are more densely concentrated in the terminal ileum. The interposition of ileal segment to a more...

  6. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature

    International Nuclear Information System (INIS)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng; Costacurta, Marco Antonio; Albertotti, Cesar Jose; Cerri, Giovanni Guido

    2000-01-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  7. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child

    OpenAIRE

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-01-01

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel’s diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the ...

  8. Intussusception caused by an inverted Meckel diverticulum: a rare cause of small bowel obstruction in adults

    Directory of Open Access Journals (Sweden)

    Mahdi Bouassida

    2011-12-01

    Full Text Available Adult intussusception due to Meckel�s diverticulum is an uncommon cause of intestinal obstruction. However, the surgeon should still be suspicious of this condition since the non specific symptoms and the rarity of it make a preoperative diagnosis uncertain. Considering the secondary nature of adult intussusception and the necessity of early surgical intervention to avoid morbidity and mortality, we report one case of intussusception due to Meckel�s diverticulum in an adult.

  9. Multiple Intussusceptions as Primary Manifestation of Peutz-Jeghers Syndrome: Report of a Case

    OpenAIRE

    Ahmad Amouzeshi; Mohammad-Reza Motie; Ali Najib Jalali

    2009-01-01

    Background: Peutz-Jeghers syndrome is a rare hereditary disorder characterized by hamartomatous polyps in the gastrointestinal tract and typical pigment lesions. It is a rare cause of multiple intussusceptions. Previous studies on Peutz-Jeghers syndrome reported only one case of multiple intussusceptions. We describe a case of appendiceal and multiple small intestine intussusceptions presenting as peritonitis in a patient with Peutz-Jeghers syndrome. Case Presentation:A 17-year-old girl prese...

  10. Functional evaluation of a modified Studer ileal neobladder

    African Journals Online (AJOL)

    A.M. Moeen

    2016-08-09

    Aug 9, 2016 ... Abstract. Objectives: To evaluate the results of using a shorter ileal segment (40 cm only) in reconstructing Studer ileal neobladder after radical cystectomy. Subjects and methods: Radical cystectomy and modified Studer ileal neobladder was performed in 60 patients for invasive bladder cancer. Only 40 cm ...

  11. Adult jejunojejunal intussusception - a case report and review of the literature. Radiological findings

    International Nuclear Information System (INIS)

    Setubal, Roger; Souza, Ricardo Pires de; Endo, Erica; Kataoka, Kazumi; Soares, Aldemir Humberto

    1996-01-01

    The author report a case of jejunojejunal intussusception caused by an adenomatous polyp in an adult. The majority of intussusception's cases occur in children with less than 2 years of age, with only 5% to 15% of cases occurring in adults. In contrast to pediatrics group intussusception, which is idiopathic in 90% of cases, adult intussusception has a demonstrable cause in more than 90% of cases. The pre-operative diagnosis is made by the association between the clinical presentation and plain abdominal radiographs, barium study of small intestine, ultrasound and computed tomography, described and discussed in this paper. (author)

  12. Ileocolic intussusception secondary to gastrointestinal stromal tumor in a 61-year-old.

    Science.gov (United States)

    Gelabert, Christopher; Torradas, Jose; Nelson, Mathew

    2014-10-01

    Intussusception is a common emergency in patients age of 3 months to 5 years. In adults, the diagnosis is infrequent but must be considered in the clinical setting of abdominal pain and vomiting. We present a case of a 61-year-old woman presenting with epigastric abdominal pain and vomiting, diagnosed with intussusception secondary to gastrointestinal stromal tumor. Serial bedside ultrasound examinations uncovered the diagnosis of intussusception, confirmed by computed tomographic scan during a paroxysm of pain. Intussusception has a much higher predilection for neoplasms in adults, with a high morbidity and mortality, so early recognition is critical in improving patient outcomes.

  13. Presentation of GIST as jejuno-jejunal intussusception

    Directory of Open Access Journals (Sweden)

    Anil Kumar

    2018-03-01

    Full Text Available Gastrointestinal stromal tumours (GISTs are rare tumour. It comprises 0.2% of gastrointestinal tumours and only 0.04% of small intestinal tumours. Usually this tumour is found in people in their 60s.These tumours can be found anywhere in the gastrointestinal tract but most commonly found in the stomach (40–60%. Patients with GISTs usually have vague and nonspecific symptoms. We present a 17year-old with complain of abdominal pain, distension, and few episodes of vomiting. All laboratory investigations were normal. The ultrasonography (USG and computed tomography (CT were suggestive of jejuno-jejunal intussusception. The patient had emergency exploratory laparotomy with resection of the segment with five cm healthy margin, and end to end anastomosis. Patient was discharged after 4 days and remains well. This case report highlights the rarity of GISTs in the concern of age (17 year old, site (Jejunum as well as presentation (intussusception.

  14. Jejunogastric intussusception in a child: A case report

    Directory of Open Access Journals (Sweden)

    Nathan Smith

    2014-11-01

    Full Text Available Jejunogastric intussusception is a rare event following gastrointestinal reconstruction. We present a case report in which jejunogastric intussuception was diagnosed in a child four years after a gastrectomy with jejunogastric reconstruction for duodenal duplication. Prompt diagnosis and emergent resection of any non-viable bowel, and revision to a Roux-En-Y anastomosis with or without pexy of the Roux limb to the colon or Y-limb mesentery appear to be the appropriate treatment for this clinical entity.

  15. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    OpenAIRE

    Srirangaraj Sreenivasan; Arunava Kali; Jothimani Pradeep

    2016-01-01

    Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, w...

  16. Perforated appendicitis: an underappreciated mimic of intussusception on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley; Schmitz, Matthew; Gawande, Rakhee; Vasanawala, Shreyas; Barth, Richard [Lucile Packard Children' s Hospital, Department of Radiology, Stanford University, Stanford, CA (United States)

    2014-05-15

    We encountered multiple cases in which the US appearance of ruptured appendicitis mimicked intussusception, resulting in diagnostic and therapeutic delay and multiple additional imaging studies. To explore the clinical and imaging discriminatory features between the conditions. Initial US images in six children (age 16 months to 8 years; 4 boys, 2 girls) were reviewed independently and by consensus by three pediatric radiologists. These findings were compared and correlated with the original reports and subsequent US, fluoroscopic, and CT images and reports. All initial US studies demonstrated a multiple-ring-like appearance (target sign, most apparent on transverse views) with diagnostic consensus supportive of intussusception. In three cases, US findings were somewhat discrepant with clinical concerns. Subsequently, four of the six children had contrast enemas; two were thought to have partial or complete intussusception reduction. Three had a repeat US examination, with recognition of the correct diagnosis. None of the US examinations demonstrated definite intralesional lymph nodes or mesenteric fat, but central echogenicity caused by debris/appendicolith was misinterpreted as fat. All showed perilesional hyperechogenicity that, in retrospect, represented inflamed fat ''walling off'' of the perforated appendix. There were four CTs, all of which demonstrated a double-ring appearance that correlated with the US target appearance, with inner and outer rings representing the dilated appendix and walled-off appendiceal rupture, respectively. All six children had surgical confirmation of perforated appendicitis. Contained perforated appendicitis can produce US findings closely mimicking intussusception. Clinical correlation and careful multiplanar evaluation should allow for sonographic suspicion of perforated appendicitis, which can be confirmed on CT if necessary. (orig.)

  17. Multidrug resistant shigella flexneri infection simulating intestinal intussusception

    Directory of Open Access Journals (Sweden)

    Srirangaraj Sreenivasan

    2016-01-01

    Full Text Available Shigella enteritis remains an important cause of mortality and morbidity in all age groups, in developing as well as developed countries. Owing to the emerging resistance to multiple antibiotics among Shigella spp., it has been recognized as a major global public health concern and warrants constant monitoring of its resistance pattern. We report a case of segmental ileitis caused by non.-ESBL producing multidrug resistant Shigella flexneri in an infant clinically mimicking intussusception, which was effectively treated by ceftriaxone.

  18. A child with colo-colonic intussusception due to a large colonic polyp

    African Journals Online (AJOL)

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic ... We report a case of CI and review the literature, focusing on the diagnosis and treatment. Key words: Children, colo-colonic intussusception, colonic polyp, intestinal obstruction ...

  19. Jejunogastric intussusception after distal gastrectomy with Roux-en-Y reconstruction: A case report.

    Science.gov (United States)

    Kawano, Fumiaki; Tashiro, Kousei; Nakao, Hironobu; Fujii, Yoshirou; Ikeda, Takuto; Takeno, Shinsuke; Nakamura, Kunihide; Nanashima, Atsushi

    2018-01-01

    Jejunogastric intussusception is a rare complication after gastric operation. Intussusception after gastric operation occurs mostly at the gastrojejunal anastomosis site and Braun anastomosis site of Billroth II reconstruction, and at the Y anastomosis site of Roux-en-Y reconstruction. However, jejunogastric intussusception after distal gastrectomy with Roux-en-Y reconstruction is very rare. We report a surgical case of jejunogastric intussusception after distal gastrectomy for gastric cancer treatment. An 82-year-old woman underwent laparoscopic distal gastrectomy for early gastric cancer treatment. Reconstruction was performed using Roux-en-Y anastomosis. Oral intake was started on postoperative day 4, however vomiting and high-grade fever occurred on postoperative day 12, after which oral intake became difficult. Anastomotic stenosis of the gastrojejunostomy was suspected, and various examinations were performed. Gastroendoscopy and computed tomography revealed an elevated lesion with ring-like folds protruding through the anastomosis site into the remnant stomach. Reoperation was performed on postoperative day 28 after a diagnosis of jejunogastric intussusception was made. It failed to reduce the intussusception, so partial resection of the gastrojejunal anastomosis was performed and Roux-en-Y reconstruction was repeated. Reconstruction was conducted after taking into consideration the recurrence of intussusception. Jejunogastric intussusceptions after distal gastrectomy is a rare complication; however, when it occurs, early diagnosis and appropriate management are necessary. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Henoch’s disease complicated by intestinal intussusception in a 5-year-old child

    Directory of Open Access Journals (Sweden)

    R. G. Artamonov

    2015-01-01

    Full Text Available Abdominal syndrome accompanied by abdominal pains is common in children with Henoch’s disease. One of the rare complications of the syndrome may be bowel intussusception. The paper describes a case of Henoch’s disease complicated intestinal intussusception.

  1. Transient small-bowel intussusceptions in adults: significance of ultrasonographic detection

    Energy Technology Data Exchange (ETDEWEB)

    Maconi, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)]. E-mail: giovanni.maconi@unimi.it; Radice, E. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Greco, S. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bezzio, C. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy); Bianchi Porro, G. [Chair of Gastroenterology, Department of Clinical Sciences, L. Sacco University Hospital, Milan (Italy)

    2007-08-15

    Aim: To investigate the frequency, clinical significance, and outcome of small-bowel intussusceptions in adults detected using ultrasound in an outpatient setting. Patients and methods: In two different retrospective (January 2001 to April 2003) and prospective (May 2003 to June 2005) periods, 33 small-bowel intussusceptions were found in 32 patients (13 females; mean age: 38.1 years) with known or suspected intestinal disease. Patients underwent diagnostic work-up to assess any organic disease. Patients with self-limiting intussusception were submitted to clinical and ultrasonographic follow-up. Results: Of the 32 patients with small-bowel intussusception, 25 were identified in the prospective series of 4487 examinations (0.53%) and seven in the retrospective series of 5342 examinations (0.15%; p = 0.002). Four patients had persistent and 28 self-limiting intussusceptions. Self-limiting intussusceptions were idiopathic in 11 patients (39%) or associated with organic diseases in 17 (Crohn's disease in 11 patients, celiac disease in three, ulcerative colitis in one patient, and previous surgery for cancer in two). Self-limiting intussusceptions were asymptomatic in 25% of patients. Conclusion: Small-bowel intussusceptions in adults are not rare and are frequently self-limiting, idiopathic, or related to organic diseases, mainly Crohn's disease and coeliac disease.

  2. Duodenal intussusception secondary to web presenting as recurrent pancreatitis in a 7-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Tu, Long H. [University of Connecticut School of Medicine, Farmington, CT (United States); Kaweah Delta Healthcare District, Graduate Medical Education, Visalia, CA (United States); Villalona, Gustavo A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); SSM Health Cardinal Glennon Children' s Hospital, Department of Pediatric Surgery, St. Louis, MO (United States); Cowles, Robert A. [Yale School of Medicine, Department of Surgery, Section of Pediatric Surgery, New Haven, CT (United States); Silva, Cicero T. [Yale School of Medicine, Department of Diagnostic Imaging, Section of Pediatric Radiology, 333 Cedar St., P.O. Box 208042, New Haven, CT (United States)

    2016-03-15

    Duodenal intussusception is a rare entity in children, with 32 cases reported in the English literature to our knowledge. Most reported cases are associated with endoluminal tubes or polyps, and the presenting symptoms are chronic and nonspecific. We report a case of duodenal intussusception in a 7-year-old girl secondary to a duodenal web and review the imaging findings. (orig.)

  3. Intussusception of the appendix mimicking appendicitis during pregnancy: a case report.

    Science.gov (United States)

    Fylstra, Donald L; Toussaint, William N; Anis, Munazza

    2009-05-01

    Intussusception occurs when a segment of bowel and its associated mesentery telescopes into the lumen of the adjacent distal bowel. Appendiceal intussusception is a rare form of ileocoloc intussusception, is rarely diagnosed preoperatively, can mimic appendicitis and has not been previously reported during pregnancy. A 31-year-old gravid woman at 27 1/7 weeks' gestation presented with symptoms suggestive of acute appendicitis and was found at laparoscopy to have complete appendiceal intussusception. The list of causes of abdominal pain in pregnancy is very long, but the presence of right-sided abdominal tenderness with guarding and rebound are highly suggestive of acute appendicitis. Regardless of preoperative imaging, because the morbidity, and even mortality, from appendicitis is the morbidity of delay, early surgical intervention is recommended. This is a case of complete appendiceal intussusception mimicking acute appendicitis, but the treatment of both conditions is appendectomy.

  4. A rare association of intussusception and celiac disease in a child

    Directory of Open Access Journals (Sweden)

    Vanessa Pacini Inaba Fernandes

    Full Text Available ABSTRACT: CONTEXT: Intussusception is a common cause of acute intestinal obstruction in the pediatric population and it is normally idiopathic. Rare cases of chronic intussusception require investigation with greater attention. CASE REPORT: We present a clinical case of a three-year-old boy with aqueous diarrhea, abdominal distension, vomiting and weight loss over a two-month period. During the investigation, abdominal ultrasound showed imaging of intussusception. The intraoperative findings showed the intussusception had resolved spontaneously. In further investigation, it was found that the diarrhea was malabsorptive and, after the patient underwent upper gastrointestinal endoscopy, a diagnosis of celiac disease was made. After a gluten-free diet was introduced, the patient showed complete remission of symptoms and regained weight, and normal growth was reestablished. CONCLUSION: If the clinical presentation of intussusception is unusual, etiological investigation should be undertaken. In this case report, celiac disease was the underlying cause.

  5. Multiple Intestinal Intussusceptions as a Complication of Severe Hyperglycemia in a Patient with Diabetic Ketoacidosis

    Directory of Open Access Journals (Sweden)

    Pooja Raghavan

    2012-01-01

    Full Text Available Intussusception in adults is a rare phenomenon, occurring in approximately 1 in 30,000 hospital admissions annually. When it does occur, the majority of cases involve an organic lesion serving as a lead point for intussusception, such as tumors or postoperative adhesions. In a small percentage of cases, a lead point is not found, and intussusception is thought to be idiopathic or secondary to a disease process contributing to dysrhythmic peristalsis of the gastrointestinal tract. A few cases of functional intussusception have been reported as being secondary to severe hyperglycemia and metabolic derangements, including metabolic acidosis and hyperkalemia, by causing impaired gastrointestinal motility. We present a case of a 23-year-old Caucasian male who presented with severe hyperglycemia and diabetic ketoacidosis. Imaging of the abdomen revealed three intussusceptions involving the small intestine, which were easily reduced manually during exploratory laparotomy.

  6. Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn’s Disease Involving the Appendix

    Directory of Open Access Journals (Sweden)

    Ebru Ozan

    2015-01-01

    Full Text Available Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point in the majority of cases. Crohn’s disease (CD may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT in a patient with active CD that involves the appendix.

  7. Endoscopic management of anastomotic bleeding in the ileal pouch with staples removal and clipping

    Directory of Open Access Journals (Sweden)

    Xian-rui Wu

    2013-01-01

    Full Text Available Objective: Postoperative pouch bleeding is a rare but detrimental complication following ileal pouch surgery. It is usually self-limited, however continuous bleeding requires inter- vention. There is limited published data on its management. Design: Ileoscopy via stoma for loop ileostomy and pouchoscopy via anus for ileal pouch were performed under sedation for the purpose of diagnosis and management of postop- erative bleeding. Results: Ileoscopy demonstrated a large, long blood clot in the lumen of efferent limb, but no sign of active bleeding was identified. Pouchoscopy showed that lumen of pouch body as well as afferent limb was filled with maroon-colored liquid stool. Pouch and neo-terminal ileum mucosa was normal. Two dislodged staples at the anastomotic line with sharp tips towards the lumen were found, with activating bleeding at one site. The staples were re- moved by biopsy forceps, and active bleeding was successfully controlled by the deploy- ment of one endoclip. Conclusions: We reported the first case that postoperative pouch bleeding, which was caused by dislodged staples, was successfully managed by endoscopic removal of the staples com- bined with clipping. Resumo: Objetivo: O sangramento pós-operatório da bolsa ileal é uma complicação rara, mas prejudi- cial após abordagem cirúrgica da bolsa ileal. Esse sangramento é geralmente autolimitado, porém, requer intervenção quando contínuo. Não há dados publicados sobre o tratamento. Método: Ileoscopia através de estoma para ileostomia em alça e endoscopia via ânus para a bolsa ileal foram realizadas sob sedação para diagnóstico e tratamento do sangramento pós-operatório. Resultados: A ileoscopia demonstrou um grande e longo coágulo sanguíneo no lúmen do ramo eferente, mas nenhum sinal de sangramento ativo foi identificado. A endoscopia da bolsa ileal mostrou que os lumens do corpo da bolsa e ramo aferente estavam cheios de fe- zes líquidas de cor marrom. A

  8. [Antenatal diagnosis and management of ileal atresia].

    Science.gov (United States)

    Dhibou, Hanane; Bassir, Ahlam; Sami, Nadia; Boukhanni, Lahcen; Fakhir, Bouchra; Asmouki, Hamid; Soummani, Abderraouf

    2016-01-01

    Ileal atresia is a rare congenital malformation which affects a small percentage of the population, with an incidence of 1 in 5000 cases. It may be suspected and diagnosed by ultrasound at the end of the second and third trimester. Obstetrical and surgical consultation is the key to success here. Eliminating a systemic disease with poor prognosis, fighting to reduce premature births and immediately entrusting the child to the surgeon are the main objectives to achieve. During surgery, the surgeon will determine the type of atresia, its location, single or multiple areas of occlusion and its length; thus surgery depends on etiology. Our study reports an interesting clinical case of ileal atresia diagnosed antenatall.

  9. Gastro-oesophageal intussusception in a young German Shepherd Dog

    International Nuclear Information System (INIS)

    Werthern, C.J. von; Montavon, P.M.; Fluckiger, M.A.

    1996-01-01

    A gastro-oesophageal intussusception in a female, six-week-old German shepherd dog was treated surgically with success. The dog was presented with acute dyspnoea and signs of shock. After laparotomy, the herniated organs were reduced from the lumen of the oesophagus into the abdomen and an imbrication of the oesophageal hiatus, an appositional fundoplication and a left-sided incisional fundopexy were performed. The dog made an uneventful recovery. Eighteen months after surgery the dog is still alive, with no clinical signs despite the persistent presence of megaoesophagus

  10. [Post-licensure passive safety surveillance of rotavirus vaccines: reporting sensitivity for intussusception].

    Science.gov (United States)

    Pérez-Vilar, S; Díez-Domingo, J; Gomar-Fayos, J; Pastor-Villalba, E; Sastre-Cantón, M; Puig-Barberà, J

    2014-08-01

    The aims of this study were to describe the reports of suspected adverse events due to rotavirus vaccines, and assess the reporting sensitivity for intussusception. Descriptive study performed using the reports of suspected adverse events following rotavirus vaccination in infants aged less than 10 months, as registered in the Pharmacovigilance Centre of the Valencian Community during 2007-2011. The reporting rate for intussusception was compared to the intussusception rate in vaccinated infants obtained using the hospital discharge database (CMBD), and the regional vaccine registry. The adverse event reporting rate was 20 per 100,000 administered doses, with the majority (74%) of the reports being classified as non-serious. Fever, vomiting, and diarrhea were the adverse events reported more frequently. Two intussusception cases, which occurred within the first seven days post-vaccination, were reported as temporarily associated to vaccination. The reporting sensitivity for intussusception at the Pharmacovigilance Centre in the 1-7 day interval following rotavirus vaccination was 50%. Our results suggest that rotavirus vaccines have, in general, a good safety profile. Intussusception reporting to the Pharmacovigilance Centre shows sensitivity similar to other passive surveillance systems. The intussusception risk should be further investigated using well-designed epidemiological studies, and evaluated in comparison with the well-known benefits provided by these vaccines. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  11. Ileocolic Intussusception in a Leukemic Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ayoub Innabi

    2016-01-01

    Full Text Available We present a rare case of intussusception in a 41-year-old man with acute myeloid leukemia without an evidence of leukemic infiltration of the bowel. The patient presented to the emergency room with right lower quadrant pain. Initially he was diagnosed with typhlitis. CT scan was done and showed ileocolic intussusception without a definitive lead point identified. Patient underwent hemicolectomy and histopathological study of the specimen did not show any leukemic infiltrate. High suspicion of intussusception should be kept in mind with leukemic patients presenting with abdominal pain.

  12. Endoscopic treatment of a large colonic polyp as a cause of colocolonic intussusception in a child.

    Science.gov (United States)

    Suksamanapun, Nutnicha; Uiprasertkul, Mongkol; Ruangtrakool, Ravit; Akaraviputh, Thawatchai

    2010-07-16

    Colocolonic intussusception is an uncommon cause of intestinal obstruction in children. The most common type is idiopathic ileocolic intussusception. However, pathologic lead points occur approximately in 5% of cases. In pediatric patients, Meckel's diverticulum is the most common lead point, followed by polyps and duplication. We present a case of recurrent colocolonic intussusception which caused colonic obstruction in a 10-year-old boy. A barium enema revealed a large polypoid mass at the transverse colon. Colonoscopy showed a colonic polyp, 3.5 centimeters in diameter, which was successfully removed by endoscopic polypectomy.

  13. Type A Dissection Involving Intimo-Intimal Intussusception Through the Aortic Valve.

    Science.gov (United States)

    Armour, Trygve; Armour, Sarah; Reddy, Pingle; Brinster, Derek

    2015-07-15

    The presentation, evaluation, management, and outcome of a case of type A circumferential dissection involving repeated retrograde intussusception of the intimal flap through the aortic valve is described in this case report. Fewer than 20 intimo-intimal intussusception cases have been described since the first report was published by Hufnagel in 1962, and outcomes have typically been poor because of delays in diagnosis. This case shows the potential for a positive outcome when the diagnosis of intimo-intimal intussusception is entertained and confirmed early in the course of treatment. Preoperative computed tomography and intraoperative transesophageal echocardiography were essential in diagnosis and operative planning.

  14. Ileocecal Intussusception with Histomorphological Features of Inflammatory Neuropathy in Adenovirus Infection

    Directory of Open Access Journals (Sweden)

    Elke Kaemmerer

    2009-01-01

    Full Text Available The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus. To our knowledge, this is the first report suggesting peristalsis disorders from inflammatory neuropathy as additional mechanism in the pathophysiological concept of adenovirus-associated ileocecal intussusception.

  15. Tuberculosis in a renal allograft recipient presenting with intussusception.

    Science.gov (United States)

    Mohapatra, A; Basu, G; Sen, I; Asirvatham, R; Michael, J S; Pulimood, A B; John, G T

    2012-01-01

    Extra-pulmonary tuberculosis (TB) is more common in renal allograft recipients and may present with dissemination or an atypical features. We report a renal allograft recipient with intestinal TB presenting 3 years after transplantation with persistent fever, weight loss, diarrhea, abdominal pain and mass in the abdomen with intestinal obstruction. He was diagnosed to be having an ileocolic intussusception which on resection showed a granulomatous inflammation with presence of acid-fast bacilli (AFB) typical of Mycobacterium tuberculosis. In addition, AFB was detected in the tracheal aspirate, indicating dissemination. He received anti-TB therapy (ATT) from the fourth postoperative day. However, he developed a probable immune reconstitution inflammatory syndrome (IRIS) with multiorgan failure and died on 11(th) postoperative day. This is the first report of intestinal TB presenting as intussusception in a renal allograft recipient. The development of IRIS after starting ATT is rare in renal allograft recipients. This report highlights the need for a high index of suspicion for diagnosing TB early among renal transplant recipients and the therapeutic dilemma with overwhelming infection and development of IRIS upon reduction of immunosuppression and starting ATT.

  16. Intussusception of the small intestine caused by a primary melanoma?

    Science.gov (United States)

    Schoneveld, M; De Vogelaere, K; Van De Winkel, N; Hoorens, A; Delvaux, G

    2012-01-01

    Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  17. Intussusception of the Small Intestine Caused by a Primary Melanoma

    Directory of Open Access Journals (Sweden)

    M. Schoneveld

    2012-01-01

    Full Text Available Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by melanoma are very rare. We report the case of a 77-year-old man who was admitted to our hospital with epigastric pain, melena and anaemia. After clinical examination, laboratory evaluation and radiological work-up the diagnosis of a jejunal intussusception was made. Exploratory laparoscopy revealed a large tumour arising from the jejunum, approximately 20 cm distal to the angle of Treitz. Small bowel resection with an end-to-end anastomosis was performed. Histological examination showed an intestinal melanoma. There are different theories concerning the origin of malignant melanoma in the small bowel. Although the small and large intestines normally contain no melanocytes, these cells have occasionally been found in the alimentary and respiratory tracts and even in lymph nodes, which supports the theory of a primary origin of melanoma at these sites. Since this was a solitary intestinal lesion and there was no history of cutaneous melanoma, we conclude that this could be an example of a very rare primary melanoma of the small intestine.

  18. Intussusception in children: Hydrostatic reduction under US guidance - own experience

    International Nuclear Information System (INIS)

    Roik, D.; Brzewski, M.; Biejat, A.; Marcinski, M.

    2008-01-01

    Intussusception in children is a common abdominal emergency. Recent years have brought a New promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. >From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital. (authors)

  19. Postsurgical recurrence of ileal Crohn's disease: an update on risk factors and intervention points to a central role for impaired host-microflora homeostasis.

    LENUS (Irish Health Repository)

    Cunningham, Michael F

    2010-07-01

    A pressing need exists to identify factors that predispose to recurrence after terminal ileal resection for Crohn\\'s disease (CD) and to determine effective prophylactic strategies. This review presents an up-to-date summary of the literature in the field and points to a role for bacterial overproliferation in recurrence.

  20. Low Voltage Electric Current Causing Ileal Perforation: A Rare Injury.

    Science.gov (United States)

    Singh, Aditya Pratap; Mathur, Vinay; Tanger, Ramesh; Gupta, Arun Kumar

    2016-01-01

    Post-electric burn ileal perforation is a rare but severe complication leading to high morbidity and mortality if there is delay in diagnosis and management. We are describing a case of electric current injury of left forearm, chest, and abdominal wall with perforation of ileum in an 8-year old boy. Patient was successfully managed by primary closure of the ileal perforation.

  1. Ileal recovery of endogenous amino acids in pigs

    NARCIS (Netherlands)

    Caine, W.

    1997-01-01

    Ileal recovery of endogenous amino acids is important for determining balanced homeostasis of protein metabolism in pigs and the true digestibility of dietary protein. In this context, the ileal recoveries of endogenous amino acids were determined in growing pigs fed guanidinated Nutrisoy protein

  2. Ileal brake activation: Macronutrient-specific effects on eating behavior?

    NARCIS (Netherlands)

    Avesaat, M. van; Troost, F.J.; Ripken, D.; Hendriks, H.F.; Aam, M.

    2015-01-01

    BACKGROUND: Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown. OBJECTIVE: The objective of

  3. Ileal brake activation: macronutrient-specific effects on eating behavior?

    NARCIS (Netherlands)

    Avesaat, van M.; Troost, F.J.; Ripken, D.; Hendriks, H.F.; Masclee, A.A.M.

    2015-01-01

    Background:Activation of the ileal brake, by infusing lipid directly into the distal part of the small intestine, alters gastrointestinal (GI) motility and inhibits food intake. The ileal brake effect on eating behavior of the other macronutrients is currently unknown.Objective:The objective of this

  4. Typhoid ileal perforation: Analysis of morbidity and mortalityin 89 ...

    African Journals Online (AJOL)

    Typhoid ileal perforation is still prevalent in many developing countries. Despite the advances in The management, the outcome in children is still very poor. To determine the morbidity and mortality of childhood typhoid ileal perforation in a tertiary referral centre in southeast Nigeria Retrospective evaluation of 89 children ...

  5. Clinical surgical Experiences with 51-ileal pouches

    International Nuclear Information System (INIS)

    Puerta, Juan D; Castano, Rodrigo; Arismendi, Ivan R

    2004-01-01

    Restorative proctocolectomy and ileal pouch (IP) has become an established surgery for patients with chronic ulcerative colitis and poliposis syndromes. The authors report the results of 8-year experience of restorative proctocolectomy and IP. Chart review was performed for 51 patients undergoing IP from 1994 through 2002. Preoperative histopathologic diagnoses were ulcerative colitis (n=39), poliposis syndromes (n=10), 2 Crohn diseases and 1 patient with colorectal cancer and extended resection. Information was obtained regarding patient demographics, type and duration of diseases, previous operations, and indications for surgery. Early (within 30 days after surgery) and late complications were noted. Follow-up included an annual function, physical examination, and biopsies of the pouch and anal transitional zone when were indicated. Of the 51 patients (24 women) with mean follow-up time of 44,5 months (range 12 -108 months), histopathologic diagnoses of ulcerative colitis were changed for Crohn's disease in 2 patients. The overall mortality rate was 2% (1 patient) one death was related to perineal sepsis 45 months after ileal pouch. The overall morbidity rate was 65% (73 complications in 33 patients; early 39%; late 49%) the mean hospitalary stance was 8, 9 days (range 6-25 days). Small bowel obstruction, septic complication and reoperation rates were 36%, 22% and 26%, respectively. The most frequent late complication was pouchitis (31,8%). The ileal pouch was removed in 1 patient, and it is functional in 50 (98%). There was a satisfactory index with 82% with excellent-good results, and 16% and 2% with regular and bad results. Restorative proctocolectomy with an IP is a safe procedure, with low mortality and major morbidity rates. Although total morbidity rate is appreciable, functional results generally are good and patient satisfaction is acceptable

  6. Adenocarcinoma in a Koff Urinary Ileal Diversion

    Directory of Open Access Journals (Sweden)

    Bradley Sherman

    2017-07-01

    Full Text Available The use of an ileal conduit as a means of treatment for bladder cancer or dysfunction is widely used and understood. However, long term surveillance of that conduit has not been strongly established and set forth as a means of screening. We present a 76yo female with a history of neurogenic bladder secondary to paraplegia who underwent the formation of a “Koff” pouch as a conduit. Nineteen years later she presents with hematuria and was found to have adenocarcinoma originating in her conduit.

  7. Tracheal left mainstem bronchus and obstructive gastric mucosal intussusception associated with esophageal atresia

    NARCIS (Netherlands)

    Tan, C. J.; Aronson, D. C.; Ekkelkamp, S.; van de Heide-Jalving, M.; Vos, A.

    1995-01-01

    A tracheal left mainstem bronchus and gastric outlet obstruction owing to gastric mucosal intussusception occurred in a child who had esophageal atresia and tracheoesophageal fistula. Bronchography and bronchoscopy, indicated because of persisting atelectasis and ventilation dependency, showed a

  8. A Rare Cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception.

    Science.gov (United States)

    Sertkaya, Mehmet; Emre, Arif; Pircanoglu, Eyüp Mehmet; Yazar, Fatih Mehmet; Tepe, Murat; Cengiz, Emrah; Isler, Ali; Vicdan, Halit

    2016-01-01

    Intussusception in adults is very rarely seen, and this cause acute abdomen. A computed tomography (CT) scan, clinical suspicion, history, and a physical examination are important for the diagnosis. We present two cases of colonic intussusceptions induced by lipoma. The cases had similar locations, diagnoses, and management. Both lipomas were located close to the cecum in the ascending colon, and a right segmental colon resection was performed in both cases. The follow-up of both cases was uneventful. Although benign lesions can cause colonic intussusception, the high incidence of malignancy in colonic lesions should always be considered. Therefore, oncologic surgical procedures should be applied. The definitive diagnosis can be made by histopathology. Sertkaya M, Emre A, Pircanoglu EM, Yazar FM, Tepe M, Cengiz E, Isler A, Vicdan H. A Rare cause of Acute Abdomen: Diagnosis and Management of Adult Colonic Intussusception. Euroasian J Hepato-Gastroenterol 2016;6(2):179-182.

  9. Ileocecal Burkitt's Lymphoma Presenting as Ileocolic Intussusception With Appendiceal Invagination and Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Sheng-Mine Wang

    2010-06-01

    Full Text Available Intussusception is a common cause of abdominal pain in children. Although most cases are idiopathic, about 10% of cases have a pathologic lead point. Burkitt's lymphoma is not a common etiology. Burkitt's lymphoma might present primarily as intussusception in children but has rarely been associated with appendicitis. We report a case in which a 10-year-old obese boy who initially presented with acute appendicitis due to ileocolic intussusception with appendiceal invagination. He underwent one-trocar laparoscopy and antibiotic treatment. The symptoms recurred 10 days after discharge. Colonoscopy disclosed ileocecal Burkitt's lymphoma as the pathological lead point. This case emphasizes the importance of the age of the patient and the anatomic location of the intussusception related to possible etiology, and hence the most appropriate surgical procedure.

  10. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    International Nuclear Information System (INIS)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun

    2007-01-01

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  11. Gastric Intussusceptions in a Red Corn Snake (Pantherophis guttatus) Associated with Cryptosporidiosis

    OpenAIRE

    Marjorie Bercier; Whitney Zoll; Justin F. Rosenberg; Robson Giglio; Lenice McCoy; William L. Castleman; Matthew D. Johnson; Darryl J. Heard

    2017-01-01

    A 3-year-old female red corn snake (Pantherophis guttatus) was presented for a three-week history of anorexia and decreased defecations. On physical examination, a soft midbody intracoelomic swelling was palpated. Transcutaneous coelomic ultrasound revealed a target-like mass on a transverse section of the stomach, suggesting the presence of a gastrointestinal intussusception. On exploratory coeliotomy, a double compounded esophagogastric and gastroduodenal intussusception was diagnosed and r...

  12. Imaging Findings of Duodenal Duplication Cyst Complicated with Duodenal Intussusception and Biliary Dilatation

    Directory of Open Access Journals (Sweden)

    Eduardo Torres Diez

    2016-01-01

    Full Text Available Duodenal duplication cyst is an extremely rare congenital anomaly usually diagnosed in childhood. However, it may remain asymptomatic for a long period. In adults it usually manifests with symptoms related to complications as pancreatitis, jaundice, or intussusception. We present the radiology findings of a patient with a duodenal intussusception secondary to a duplication cyst. The usefulness of the magnetic resonance (MR in this case is highlighted.

  13. A comparison of manual versus hydrostatic reduction in children with intussusception: Single-center experience

    Directory of Open Access Journals (Sweden)

    Servet Ocal

    2014-01-01

    Full Text Available Objective: In recent years several techniques have been recommended for intussusception treatment. In this study, an evaluation was made of intussusception cases that presented at our clinic and had reduction applied together with saline under ultrasonography (USG and cases, which were surgically treated. Patients and Methods: A retrospective evaluation was made of the records of 72 cases treated for a diagnosis of intussusception between January 2010 and July 2012. Patients were evaluated demographics, clinical presentation, management strategy, during the hospitalisation and outcome. Results: A total of 72 cases which consists of 44 male and 28 female with age range between 5 and 132 months were treated with a diagnosis of intussusception. USG was applied to all cases on initial presentation. As treatment, hydrostatic reduction (HR together with USG was applied to 47 cases. Of these, the HR was unsuccessful in 13 cases. Surgical treatment was applied to 38 cases. Of these cases, ileocolic intussusception was observed in 30 cases, ileoileal in seven cases and colocolic in one case. Meckel diverticulum was determined in five of these cases, polyps in two cases, lymphoma in two cases, lymph nodule in one case and 28 cases were observed to be idiopathic. There was no mortality in any case. Conclusion: HR together with USG is a safe technique in the treatment of intussusception, which also shortens the duration of hospitalisation and significantly reduces the treatment costs.

  14. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma

    Directory of Open Access Journals (Sweden)

    Tiziana Casiraghi

    2016-01-01

    Full Text Available Introduction. Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions. Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation. A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion. Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%; since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  15. Intestinal Obstruction Caused by Ileocolic and Colocolic Intussusception in an Adult Patient with Cecal Lipoma.

    Science.gov (United States)

    Casiraghi, Tiziana; Masetto, Alessandro; Beltramo, Massimo; Girlando, Mauro; Di Bella, Camillo

    2016-01-01

    Introduction . Intussusception is a rare clinical entity in adults (<1% of intestinal obstructions). Colonic intussusception is even rarer, particularly when caused by lipomas. Case Presentation . A 47-year-old woman presented to our emergency department complaining of abdominal pain with vomiting and diarrhoea. X-ray and CT showed bowel obstruction due to ileocolonic and colocolonic intussusception; a giant colonic lipoma (9 × 4 × 4 cm) was recognizable immediately distally to the splenic flexure of the colon. The patient underwent emergency laparotomy and right hemicolectomy. Assessment of the resected specimen confirmed the diagnosis of giant colonic polypoid lesion near to the ileocecal valve, causing a 12 cm long intussusception with moderate ischemic damage. Conclusion . Colonic obstruction due to intussusception caused by lipomas is a very rare condition that needs urgent treatment. CT is the radiologic modality of choice for diagnosis (sensitivity 80%, specificity near 100%); since the majority of colonic intussusceptions are caused by primary adenocarcinoma, if the etiology is uncertain, the lesion must be interpreted as malignant and extensive resection is recommended. At present, surgery is the treatment of choice and determines an excellent outcome.

  16. Delayed Presentation of Intussusception with Perforation after Splenectomy in Patient with Blunt Abdominal Trauma

    Science.gov (United States)

    Afifi, Ibrahim; Al-Thani, Hassan; Attique, Sajid; Khoschnau, Sherwan; El-Menyar, Ayman; Latifi, Rifat

    2013-01-01

    Adult intussusception (AI) following blunt abdominal trauma (BAT) is a rare surgical condition. We present a case of delayed diagnosis of ileocecal junction intussusception with a perforation of small bowel in a 34-year-old male with a history of fall from height. Initial exploratory laparotomy revealed shattered spleen requiring splenectomy. Initial abdominal computerized tomography scanning (CT) scan showed dilated small bowel with no organic obstruction. Patient started to improve with partial distention and was shifted to rehabilitation unit. On the next day, he experienced severe abdominal distention and vomiting. Abdominal CT showed characteristic intussusception at the distal ileum. Secondary exploratory laparotomy revealed severe adhesions of stomach and small bowel to the anterior abdominal wall with dilated small bowel loops and intussusception near the ileocecal junction with perforation of small bowel. The affected area was resected and side-to-side stapled anastomosis was performed. Though small bowel intussusception is a rare event, BAT patients with delayed symptoms of bowel obstruction should be carefully evaluated for missed intussusception. PMID:24455385

  17. Single-Access Laparoscopic Surgery for Ileal Disease

    Directory of Open Access Journals (Sweden)

    Mohamed Moftah

    2012-01-01

    Full Text Available Aim. Single-access laparoscopic surgery (SALS can be effective for benign and malignant diseases of the ileum in both the elective and urgent setting. Methods. Ten consecutive, nonselected patients with ileal disease requiring surgery over a twelve month period were included. All had a preoperative abdominopelvic computerized tomogram. Peritoneal access was achieved via a single transumbilical incision and a “surgical glove port” utilized as our preferred access device. With the pneumoperitoneum established, the relevant ileal loop was located using standard rigid instruments. For ileal resection, anastomosis, or enterotomy, the site of pathology was delivered and addressed extracorporeally. Result. The median (range age of the patients was 42.5 (22–78 years, and the median body mass index was 22 (20.2–28 kg/m2. Procedures included tru-cut biopsy of an ileal mesenteric mass, loop ileostomy and ileotomy for impacted gallstone extraction as well as ileal (=3 and ileocaecal resection (=4. Mean (range incision length was 2.5 (2–5 cm. All convalescences were uncomplicated. Conclusions. These preliminary results show that SALS is an efficient and safe modality for the surgical management of ileal disease with all the advantages of minimal access surgery and without requiring a significant increase in theatre resource or cost or incurring extra patient morbidity.

  18. Determination of basal ileal endogenous losses and standardized ileal digestibility of amino acids in barley fed to growing pigs

    DEFF Research Database (Denmark)

    Spindler, Hanna Katharina; Mosenthin, Rainer; Rosenfelder, Pia

    2016-01-01

    digestible content (cAID) and total crude protein (CP) and AA can be considered as alternative approach to obtain more accurate values for IAAend and SID of AA in cereal grains.MethodsEight hulled barley genotypes were used, with barley being the only source of CP and AA in the assay diets. The diets......BackgroundBasal ileal endogenous amino acid (AA) losses (IAAend) and standardized ileal digestibility (SID) values of cereal grains, such as barley, are apparently underestimated when determined according to the nitrogen (N)-free method. Regression analysis between the dietary apparent ileal...... to tabulated values. Moreover, these SID values were greater than those reported in literature, based on correction of apparent ileal digestibility (AID) of CP and AA for their IAAend values. Summarized, the results of the present regression analysis indicate greater IAAend in barley-based diets compared...

  19. Gastric Intussusceptions in a Red Corn Snake (Pantherophis guttatus Associated with Cryptosporidiosis

    Directory of Open Access Journals (Sweden)

    Marjorie Bercier

    2017-01-01

    Full Text Available A 3-year-old female red corn snake (Pantherophis guttatus was presented for a three-week history of anorexia and decreased defecations. On physical examination, a soft midbody intracoelomic swelling was palpated. Transcutaneous coelomic ultrasound revealed a target-like mass on a transverse section of the stomach, suggesting the presence of a gastrointestinal intussusception. On exploratory coeliotomy, a double compounded esophagogastric and gastroduodenal intussusception was diagnosed and reduced surgically. A gastropexy was also performed to prevent recurrence. On histopathology, the gastric glandular mucosa showed moderate to marked proliferation. Diffusely lining the luminal surface of glandular epithelium and free within the lumen were a myriad of protozoa consistent with Cryptosporidium sp. A diagnosis of chronic proliferative gastritis due to Cryptosporidium sp. was made based on these findings. Intussusceptions are rare in reptiles and are infrequently reported in snakes. This is the first report of a double compounded intussusception in a nonmammalian species and the first report of an intussusception involving the stomach in a snake with gastritis due to Cryptosporidium sp.

  20. Neutral detergent fiber increases endogenous ileal losses but has no effect on ileal digestibility of amino acids in growing pigs.

    Science.gov (United States)

    Mariscal-Landín, Gerardo; Reis de Souza, Tércia Cesária; Bayardo Uribe, Alejandro

    2017-02-01

    Two experiments were conducted to determine the effect of neutral detergent fiber (NDF) on endogenous amino acids and protein ileal losses; and also apparent ileal digestibility (AID), and standardized ileal digestibility (SID) of amino acids and crude protein. Sixteen barrows were fed four protein-free diets containing graded NDF levels in Experiment 1. NDF was a mixture of sugarcane bagasse and corn leaves (SBCL). Twenty-four barrows were fed diets with soybean protein concentrate (SPC) or casein as protein sources and SBCL or corncobs (CC) as NDF sources in Experiment 2. In Experiment 1, a linear increase (P protein ileal losses was observed with increased NDF levels, except for arginine, histidine, methionine and proline. In Experiment 2, protein (P Protein and NDF sources significantly affected (P protein, which was higher in casein diets (92.8%) and CC diets (92.7%). NDF source had no effect (P > 0.05) on SID of amino acids. Overall, this study showed that NDF increased endogenous amino acid and protein ileal losses, but did not affect ileal digestibility of amino acids. © 2016 Japanese Society of Animal Science.

  1. Epidemiology of childhood intussusception in Bangladesh: Findings from an active national hospital based surveillance system, 2012-2016.

    Science.gov (United States)

    Satter, Syed M; Aliabadi, Negar; Yen, Catherine; Gastañaduy, Paul A; Ahmed, Makhdum; Mamun, Abdullah; Islam, Khaleda; Flora, Meerjady S; Rahman, Mahmudur; Zaman, K; Rahman, Mustafizur; Heffelfinger, James D; Luby, Stephen P; Gurley, Emily S; Parashar, Umesh D

    2017-09-20

    Rotavirus vaccines have significantly decreased the burden of diarrheal diseases in countries that have introduced them into their immunization programs. In some studies, there has been a small association between rotavirus vaccines and intussusception in post-marketing surveillance, highlighting the importance of tracking incidence before and after vaccine introduction. The objective of this study was to describe the epidemiology of intussusception among Bangladeshi children pre-vaccine introduction. We conducted active, hospital-based surveillance for intussusception at 7 tertiary care hospitals with pediatric surgical facilities during July 2012 to September 2016. Hospitalized children under 2years of age were identified according to Brighton Collaboration level 1 criteria for intussusception. The frequency and proportion of intussusception among overall surgical admissions, as well as the demographic and clinical information of the cases is described. Overall 153 cases of intussusception among children <2years-old were identified at participating sites over the enrolment period, confirmed by Level 1 Brighton criteria. These cases represented 2% of all surgical admissions under 2years of age. One hundred twelve cases (73%) were male; the median age was 7months; and the median duration of hospitalization was 7days. One hundred forty-six (95%) children with intussusception required surgery, and 11 (7%) died. Confirmed cases of intussusception represented nearly 2% of pediatric surgical admissions at tertiary referral centers in Bangladesh during the study period and 7% of children with intussusception died. Given the high burden of rotavirus disease in Bangladesh, vaccine introduction is warranted, however, further studies after introduction of rotavirus vaccine are necessary to determine any association between vaccine and intussusception in this setting. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Rare presentation of pancreatitis secondary to intussusception of duodenal duplication cyst, a pediatric case report

    Directory of Open Access Journals (Sweden)

    Valentina Shakhnovich

    2014-12-01

    Full Text Available Duodenal duplication cysts are rare congenital malformations of which there is limited literature in the pediatric population. The most common presentation in symptomatic patients is abdominal pain and pancreatitis. We present a case of a 14 year old female that presented with emesis, abdominal pain, weight loss, and admission biochemical profile concerning for acute pancreatitis in conjunction with severe hypochloremic, hypokalemic metabolic alkalosis. Further imaging was highly suggestive of duodeno-duodenal intussusception causing obstruction of the pancreatic duct. Patient was taken emergently to the operating room for exploration. Patient underwent laparoscopic assisted reduction of intussusception and resection of duodenal duplication cyst. Patient tolerated the surgery well, and was able to be discharged home in stable condition soon after. There have been no cases reported in the literature that describe pancreatitis secondary to intussusception of duodenal duplication cyst. When diagnosed early, these patients can be safely managed laparoscopically even in emergent settings.

  3. Reduction of intussusception by air insufflation in children: recent three-year experience

    International Nuclear Information System (INIS)

    Lee, In Jae; Lim, Hyo Keun; Lee, Kyung Hwan; Yun, Ku Sub; Seo, Gwy Suk; Bae, Sang Hoon

    1994-01-01

    This study was conducted to evaluate success and perforation rates of pneumatic reduction and to find the predictors of reduction failure. We reviewed 224 cases of pediatric intussusception diagnosed by air-enema between July, 1989 and June, 1992. The mean age was 9.8 months(range, 1 month to 3 years). Logistic regression analysis was used to find predictors of reduction failure. Successful reduction was achieved in 197 cases(87.9% of success rate). Bowel perforation occurred in two cases(0.9% of perforation rate). There were two statistically significant predictors of failure;(1) ileoileocolic intussusception(ρ < .001), (2) long duration of symptom (ρ < .001). Surgery was performed in 26 cases (11.6%), of which seven required bowel resection. Pneumatic reduction is a useful means in the management of pediatric intussusception with a high success rate and no mortality

  4. Synchronous adenocarcinomas of the colon presenting as synchronous colocolic intussusceptions in an adult

    Directory of Open Access Journals (Sweden)

    Chen Chuang-Wei

    2012-12-01

    Full Text Available Abstract Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

  5. Neuroendocrine carcinoma as a rare cause of jejunal intussusception in an adult. Management and literature review.

    Science.gov (United States)

    Sahsamanis, Georgios; Mitsopoulos, Georgios; Deverakis, Titos; Terzoglou, Alexandra; Evangelidis, Paschalis; Dimitrakopoulos, Georgios

    2017-05-01

    Intussusception of the small bowel is an uncommon condition, with the majority of cases being observed during infancy. A number of points are responsible, with benign and malignant lesions of the small intestine being the most common. Herein, we present the case of a 75-year-old male patient with vague abdominal pain and black stool during defecation, who underwent surgery due to jejunal intussusception. Pathology report demonstrated a neuroendocrine carcinoma as the underlying cause for his condition, with no additional metastases during the initial diagnosis. Although a conservative approach for management of intussusception is viable, the possibility of gastric outlet obstruction and the presence of malignancy as the primary point usually lead to urgent surgery. In the case of malignancy, adjuvant chemotherapy or additional symptomatic therapy with close follow-up may be required depending on tumor's grade and aggressiveness.

  6. Appendix Invagination Mimicking Ileocecal Intussusception in a Pediatric Patient: A Case Report.

    Science.gov (United States)

    Aybay, Muhsin Nuh; Erol, Seyit; Kaya, Hasan Emin; Guler, Ibrahim

    2016-11-01

    Appendix invagination is a rare cause of right lower quadrant abdominal pain. Clinical findings are not specific and can mimic a wide range of diseases. An 8-year-old girl was admitted with abdominal pain lasting for 2 weeks. Clinical and radiologic findings suggested ileocecal intussusception initially. A failed hydrostatic reduction attempt and subsequent abdominal ultrasound and computed tomography studies showed that the underlying pathology was invagination of the vermiform appendix. The patient was managed conservatively and spontaneous reduction was observed during follow-up. She underwent appendectomy 9 months later due to chronic appendicitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Appendix invagination should be kept in mind while evaluating patients with suspected ileocecal intussusception. In distinguishing between these two conditions, a blind-ending invaginating segment is an important clue in favor of appendix intussusception. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Evidence for validity of ileal digestibility coefficients in monogastrics.

    Science.gov (United States)

    Columbus, Daniel; de Lange, Cornelis F M

    2012-08-01

    Measures of amino acid (AA) digestibility are used widely to estimate bioavailability of AA in feed and food ingredients for monogastric animals. In principle, the digestibility assay is simpler than in vivo assessments of AA bioavailability and allows for simultaneous estimation of the bioavailability of all AA in an experimental diet. It is generally assumed that absorption of intact AA in the hindgut of monogastrics is minimal, even though colonocytes do contain AA transporters and have been shown to absorb AA. This assumption is supported by the observation that infusion of AA into the hindgut does not improve nitrogen balance in monogastrics. In addition, growth performance of monogastrics is more highly correlated with ileal than faecal AA digestibility. Therefore, ileal digestibility coefficients provide better estimates of AA bioavailability than faecal digestibility coefficients. Measures of apparent ileal digestibility (AID) of AA are confounded with endogenous gut AA losses (EAAL). The curvilinear increase in AID of AA with increasing dietary AA level has been attributed to the relatively large contribution of EAAL to total ileal AA flows at low dietary AA levels. Subtracting basal EAAL from total ileal AA flows yields standardized ileal digestibility (SID) coefficients that appear to be more additive than AID coefficients in mixtures of feed ingredients. An implicit assumption when using SID AA coefficients in diet formulation is that the post-absorptive utilization of AA is not influenced by the dietary protein source. This assumption appears inappropriate when using feed or food ingredients that have been over-heated, induce large amounts of EAAL, or contain substantial amounts of fermentable fibre. Improved understanding of processes that contribute to the discrepancy between bioavailability and ileal digestibility will allow a more effective use of AA digestibility coefficients in diet formulation.

  8. Ultrasound-guided hydrostatic reduction of intestinal intussusception: description of three cases

    Directory of Open Access Journals (Sweden)

    Martha Hanemann Kim

    2008-09-01

    Full Text Available With the objective of reporting the technique of ultrasound-guided hydrostatic reduction of intestinal intussusception, three cases with confirmed diagnosis of the disease submitted to reduction with this technique are described. All cases had successful reductions with no complications. One patient experienced a recurrence of the invagination eight days after treatment, which was surgically corrected. The technique of hydrostatic reversal of intestinal intussusception guided by ultrasound may be used in place of the conventional barium enema, since it is a minimally invasive and safe method, with high rates of success and few complications.

  9. Invaginated meckel's diverticulum: A rare cause of small intestine intussusception in adults

    International Nuclear Information System (INIS)

    Rana, N. A.; Rathore, M. O.; Khan, M. U.

    2013-01-01

    Intussusception is commonly seen in infants. It is occasionally found in adults usually due to carcinomas, colonic diverticuli, polyps and rarely Meckel's diverticulum. An adult male presented with upper abdominal pain, nausea, anorexia and loose stools. The initial investigative workup was unremarkable and patient responded to treatment given for acute gastroenteritis. After 3 days, the pain recurred in right iliac fossa with rebound tenderness and leukocytosis. Surgery was performed with provisional diagnoses of acute appendicitis and/or acute Meckel's diverticulitis. Per-operative findings revealed invaginated Meckel's diverticulum causing non-obstructing intussusception. (author)

  10. [Is intestinal malrotation the cause of intussusception? Waugh's syndrome, a case report].

    Science.gov (United States)

    Gil-Vargas, Manuel; Sol-Meléndez, Ana Karen; Miguel-Sardaneta, Mariana Lee

    2016-01-01

    Waugh's syndrome is the combination of intussusception and intestinal malrotation. The first case was described in 1911, with few cases being reported since then. A 7 month-old infant with fever, vomiting and rectal bleeding. Distension and an abdominal mass was found on examination. An exploratory laparotomy was preformed that found a combination of intussusception and intestinal malrotation, which was treated succesfully. We consider that this combination is not sufficiently diagnosed very often, leading to its disappearance. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  11. Digestibilidade ileal aparente e verdadeira de aminoácidos de farinhas de carne e ossos para suínos Apparent and true ileal digestibility of meat and bone meals amino acids for swine

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Pozza

    2004-10-01

    Full Text Available O experimento foi conduzido com o objetivo de determinar a digestibilidade ileal aparente e verdadeira dos aminoácidos de seis diferentes farinhas de carne e ossos. Foram utilizados 12 suínos mestiços, machos castrados, com peso médio inicial de 52,5 ± 5,1 kg. Os animais foram previamente submetidos à cirurgia para implantação de cânula "T" simples no íleo terminal, e, após 20 dias de recuperação, foram distribuídos em um delineamento experimental de blocos ao acaso, com seis tratamentos, quatro repetições e um animal por unidade experimental. Ao término das duas primeiras repetições, os tratamentos foram redistribuídos para evitar que o mesmo animal recebesse a mesma dieta em duas repetições consecutivas. Os tratamentos consistiram de uma dieta isenta de proteína à base de açúcar, amido, óleo e casca de arroz, tendo como única fonte protéica as farinhas de carne e ossos. Os coeficientes de digestibilidade ileal aparente da lisina, treonina e metionina, das diferentes farinhas de carne e ossos variaram de 54,87 a 74,80; 62,62 a 81,19 e 72,35 a 85,46%, respectivamente, e a variação entre os coeficientes de digestibilidade ileal verdadeira foram de 57,00 a 76,08; 66,26 a 83,07 e 73,76 a 86,39%, respectivamente, para a lisina, treonina e metionina. As farinhas de carne e ossos apresentaram grande variação, em função das diferentes amostras, quanto aos coeficientes de digestibilidade ileal aparentes e verdadeiros dos aminoácidos.The experiment was carried out to determine the apparent and true ileal digestibility of amino acids from six different meat and bone meals. Twelvecrossbred swines, castrated males, averaging 52.5 ± 5.1 kg initial weight, were used. The animals were previously submitted to the simple T canula surgery implantation at the terminal ileum and, after twenty days of recovery period, they were allotted to a randomized blocks design, with six treatments, four replicates and one animal per

  12. Ileal microbiota of growing pigs fed different dietary calcium phosphate levels and phytase content and subjected to ileal pectin infusion.

    Science.gov (United States)

    Metzler-Zebeli, B U; Vahjen, W; Baumgärtel, T; Rodehutscord, M; Mosenthin, R

    2010-01-01

    Two experiments with growing pigs were conducted to determine the effects of dietary P and Ca levels, phytase supplementation, and ileal pectin infusion on changes in bacterial populations in the ileum and on ileal and fecal fermentation patterns. Growing pigs (BW 30.1 +/- 1.3 kg) were fitted with simple T-cannulas at the distal ileum and were fed a low-P corn-soybean meal control diet (3 g of P/kg), or the control diet supplemented with either 15 g of monocalcium phosphate (MCP)/kg (Exp. 1) or 1,000 phytase units of phytase/kg (Exp. 2). Daily infusion treatments consisted of either 60 g of pectin dissolved in 1.8 L of demineralized water or 1.8 L of demineralized water as a control infusion, infused via the ileal cannula. In each experiment, 8 barrows were assigned to 4 dietary treatments according to a double incomplete 4 x 2 Latin square design. The dietary treatments in Exp. 1 were the control diet with water infusion, the control diet with pectin infusion, the MCP diet with water infusion, or the MCP diet with pectin infusion. In Exp. 2, the pigs received the same control treatments as in Exp. 1 and the phytase diet in combination with water or pectin infusion. Gene copy numbers of total bacteria, Lactobacillus spp., Lactobacillus reuteri, Lactobacillus amylovorus/Lactobacillus sobrius, Lactobacillus mucosae, Enterococcus spp., Enterococcus faecium, Enterococcus faecalis, bifidobacteria, the Clostridium coccoides cluster, the Clostridium leptum cluster, the Bacteroides-Prevotella-Porphyrmonas group, and Enterobacteriaceae were determined by quantitative PCR in DNA extracts of ileal digesta. In Exp. 1, addition of MCP reduced ileal gene copy numbers of Enterococcus spp. (P = 0.048), E. faecium (P = 0.015), and the C. leptum cluster (P = 0.028), whereas pectin infusion enhanced (P = 0.008) ileal d-lactate concentration. In Exp. 2, supplemental phytase led to greater ileal gene copy numbers of the C. coccoides (P = 0.041) and C. leptum (P = 0.048) clusters and

  13. Understanding about diagnosis of acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT

    International Nuclear Information System (INIS)

    Jiang Ruizhou; Chen Jincheng

    2009-01-01

    Objective: To have a further study of the value of MSCT in diagnosing acute small bowel retrograde intussusception in adults by means of 64-slice-spinal CT. Methods: A 46-year-old female patient with the history of abdominal operation was found having acute mechanical small bowel obstruction through plain X-ray radiograph. 64-slice MSCT was performed afterwards (plain scan + 3 stage contrast scans). Hence, evidence is provided for operation. Results: Using the technique of MSCT for the patient can promptly approach the diagnosis of jejuno-jejunal intussusception with severe bowel obstruction; no small bowel tumor or other organic lesion found in this case. With the patient who has the history of abdominal operations, MSCT can predict the reason of adhesion causing bowel intussusception, and provide the evidence for operation; whereas MSCT with contrast media offers a further investigation of the blood supply to the bowels through SMA, and observation of blood circulation through the intussuscepting site, which represents venous congestion of intussusception. This case is a retrograde small bowel intussusception and confirmed with operation evidence. A greater amount of gas and fluid is accumulated between the dilated space of middle-distal portion of intussusceptum and intussuscipiens. Nevertheless, less gas at the proximal portion and that can be an important sign for retrograde intussusception. Conclusion: MSCT is a good choice of examination for diagnosis of adult's intussusception. As the literature mentioned the advantages of MSCT for observing the circulation of intussusceptum and whether the diagnosis is antegrade or retrograde intussusception is also essential. (authors)

  14. Effective dose at pneumatic reduction of paediatric intussusception

    International Nuclear Information System (INIS)

    Heenan, S.D.; Kyriou, J.; Fitzgerald, M.; Adam, E.J.

    2000-01-01

    AIM: The purpose of this study was to assess screening times and resulting dose implication at pneumatic reduction of intussusception in the paediatric age group and to examine the relationship with the outcome of the procedure. MATERIALS AND METHODS: We retrospectively reviewed the case notes and departmental records of 143 children who had undergone a total of 153 pneumatic reductions in our department over a 4-year period. Success rates, screening times and available dose-area products (DAP) were recorded. The DAPs were converted to effective dose (ED) for 77 procedures. RESULTS: A 76.5% (117/153) success rate was achieved with a recurrence rate of 6.5% and only one complication: a perforation. Screening times were recorded in 137 reductions and ranged from 15 s to 22.6 min. Although the longest screening time was associated with an unsuccessful outcome, the second longest time of 21 min was successful. This gave a DAP of 1278 cGy cm 2 and an ED of 12.73 mSv, which is equivalent to approximately 400 abdominal films for a 1-year-old. A lifetime risk of fatal cancer of one in 1000 was achieved, assuming the worst case, after a screening time of 30 min on our conventional fluoroscopy unit. CONCLUSION: Our success rate compares well with other centres. Our institution is a tertiary referral centre and the occasional long screening time may reflect the delay and complex nature of the patients referred. Persistence at air reduction may be successful and the success rate increases with delayed attempts but the risks of the increasing radiation burden must be weighed against the risks of emergency surgery and anaesthesia. Heenan, S.D. (2000)

  15. Tracking (Poly)phenol components from raspberries in ileal fluid.

    Science.gov (United States)

    McDougall, Gordon J; Conner, Sean; Pereira-Caro, Gema; Gonzalez-Barrio, Rocio; Brown, Emma M; Verrall, Susan; Stewart, Derek; Moffet, Tanya; Ibars, Maria; Lawther, Roger; O'Connor, Gloria; Rowland, Ian; Crozier, Alan; Gill, Chris I R

    2014-07-30

    The (poly)phenols in ileal fluid after ingestion of raspberries were analyzed by targeted and nontargeted LC-MS(n) approaches. Targeted approaches identified major anthocyanin and ellagitannin components at varying recoveries and with considerable interindividual variation. Nontargeted LC-MS(n) analysis using an orbitrap mass spectrometer gave exact mass MS data which were sifted using a software program to select peaks that changed significantly after supplementation. This method confirmed the recovery of the targeted components but also identified novel raspberry-specific metabolites. Some components (including ellagitannin and previously unidentified proanthocyanidin derivatives) may have arisen from raspberry seeds that survived intact in ileal samples. Other components include potential breakdown products of anthocyanins, unidentified components, and phenolic metabolites formed either in the gut epithelia or after absorption into the circulatory system and efflux back into the gut lumen. The possible physiological roles of the ileal metabolites in the large bowel are discussed.

  16. Giant submucosal lipoma cause colo-colonic intussusception. A case report and review of literature.

    Science.gov (United States)

    Grasso, Emanuele; Guastella, Tommaso

    2012-01-01

    Lipoma of the large intestine is rare, with a reported incidence ranging between 0.2% and 4.4%. We present a case of a giant colonic lipoma causing descending-colonic intussusception. A 54-year-old woman visited our emergency room with sudden onset of intermittent abdominal cramps. She was nauseous and had rectal blood loss for three days. Physical examination showed a tender palpable mass in the left lower abdominal quadrant. Rectal examination showed little blood on the glove. A CT scan demonstrated a clear intussusception of the descending-colonic (Fig. 1). Since the clinical presentation was that of an imminent ileus a laparotomy was performed. The intussusception was found in the descending coloni (Fig. 2), en-bloc resection with left hemicolectomy and was performed with end-to-end anastomosis. Lipomas of the gastrointestinal tract are rare conditions first described by Baurer in 1757. Lipomas in the intestinal tract are still relatively rare, however, being present in only 0.2% of a large autopsy series of 60 000 cases reported in 1955. In 90% of cases, lipoma of the colon are localized at submucous level. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. Accurate preoperative diagnosis is difficult and lipoma is often mistaken for adenomatous polyp or carcinoma. Differential diagnosis includes malignancy, diverticulosis, adenomatous polyps and previous anastomosis. CT is the examination of choice. Surgical approach remains the treatment of choice for large colon lipoma.

  17. Tuberculosis mimicking ileocecal intussusception in a 5-month-old girl

    NARCIS (Netherlands)

    J.E.M. de Steenwinkel (Jurriaan); G.J.A. Driessen (Gertjan); M.H. Kamphorst-Roemer (Margreet); A.G.M. Zeegers (Antoine); A. Ott (Alewijn); M. van Westreenen (Mireille)

    2008-01-01

    textabstractA 5-month-old girl was diagnosed with tuberculosis, mimicking ileocecal intussusception. The mother of the patient was later diagnosed with renal tuberculosis attributable to the same (unique) Mycobacterium tuberculosis strain. Possibly, that transmission occurred by aspiration or

  18. Sarcomatoid Carcinoma of the lung: A rare case of three small intestinal intussusceptions and literature review

    Directory of Open Access Journals (Sweden)

    Angela Romano

    2015-01-01

    Conclusion: There are rare reports of small intestinal intussusceptions caused by metastatic lung carcinosarcoma, this presentation shows the third case in literature. Physicians should be more alert to symptoms or signs indicating GI metastais in patients with a history of lung cancer.

  19. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative?

    Directory of Open Access Journals (Sweden)

    V. V. S. S. Chandrasekharam

    2011-01-01

    Full Text Available Aim: To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance. Materials and Methods: This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI. Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced. Results: Eleven patients [age 7.8 (±2.8 months] were operated over a period of 1 year. Ten (90.9% patients had ileocolic intussusception, which got completely reduced, but one (9% had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6 min. No patient had bowel ischemia and there were no intra- or postoperative complications. Conclusions: LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction.

  20. Intussusception during pregnancy after laparoscopic Roux-en-Y gastric bypass

    NARCIS (Netherlands)

    Bokslag, Anouk; Jebbink, Jiska; de Wit, Laurens; Oudijk, Martijn; Ribbert, Lucie; Tahri, Sabrin; van Pampus, Mariëlle

    2014-01-01

    In fertile women, the laparoscopic Roux-en-Y gastric bypass (LRYGB) is being increasingly performed. Pregnancy and LRYGB both give an increased risk of intussusception, which can lead to bowel necrosis, sepsis and preterm labour. We describe two pregnant women with a history of LRYGB who presented

  1. Influence of forage inclusion in the diet on ileal and total tract digestibility

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Carlson, Dorthe; Lærke, Helle Nygaard

    2012-01-01

    with clover–grass silage from weaning, were fi tted with a T-cannula at the terminal ileum at approximate 30 kg BW. For each of the 3 types of forage, 2 balance trials with a 4 wk interval were carried out. Two pigs in each test were fed the basal diet and 6 others were fed the basal diet plus forage......The present investigation aimed to study the ileal and total tract digestibility of 3 forages (clover–grass, clover–grass silage, and fi eld pea (Pisum sativum)–barley (Hordeum vulgare) silage) supplemented to a basal diet. A total of 24 pigs, adapted to eating forages by supplementing a basal feed...... some separation of the digesta collected from the T-cannula. The forages had, as expected, a lower total tract DM and energy digestibility than the basal diet (P

  2. Potential intussusception risk versus health benefits from rotavirus vaccination in Latin America.

    Science.gov (United States)

    Desai, Rishi; Parashar, Umesh D; Lopman, Benjamin; de Oliveira, Lucia Helena; Clark, Andrew D; Sanderson, Colin F B; Tate, Jacqueline E; Matus, Cuahtemoc Ruiz; Andrus, Jon K; Patel, Manish M

    2012-05-01

    With the recent postlicensure identification of an increased risk of intussusception with rotavirus vaccine, the 14 Latin American countries currently using rotavirus vaccine must now weigh the health benefits versus risks to assess whether to continue vaccination. To inform policy considerations, we estimated excess intussusception cases and mortality potentially caused by rotavirus vaccine for each of the 14 countries and compared these estimates to hospitalizations and deaths expected to be averted through vaccination. We used regional rotavirus disease burden and rotavirus vaccine efficacy data, global natural intussusception and regional rotavirus vaccine-related risk estimates, and country-specific diphtheria, tetanus, and pertussus vaccination coverage rates to estimate rotavirus vaccine coverage rates. We performed a probabilistic sensitivity analysis to account for uncertainty in these parameters. For an aggregate hypothetical birth cohort of 9.5 million infants in these 14 countries, rotavirus vaccine would annually prevent 144 746 (90% confidence interval [CI], 128 821-156 707) hospitalizations and 4124 deaths (90% CI, 3740-4239) due to rotavirus in their first 5 years of life but could cause an additional 172 hospitalizations (90% CI, 126-293) and 10 deaths (90% CI, 6-17) due to intussusception, yielding benefit-risk ratios for hospitalization and death of 841:1 (90% CI, 479:1 to 1142:1) and 395:1 (90% CI, 207:1 to 526:1), respectively. In an uncertainty analysis using 10 000 simulations of our probabilistic parameters, in comparing rotavirus disease averted to intussusception events caused, the hospitalization ratio was never below 100:1, and our death ratio fell below 100:1 only once. The health benefits of vaccination far outweigh the short-term risks and support continued rotavirus vaccination in Latin America.

  3. The diagnostic role of abdominal CT imaging findings in adults intussusception: Focused on the vascular compromise

    International Nuclear Information System (INIS)

    Park, Sung Bin; Ha, Hyun Kwon; Kim, Ah Young; Lee, Seung Soo; Kim, Hye Jin; Park, Beom Jin; Jin, Yong Hyun; Park, Seong Ho; Kim, Kyoung Won

    2007-01-01

    Intussusception is defined as telescoping of one segment of the gastrointestinal tract into an adjacent one. Unlike that in children, adult intussusception is a relatively rare condition. More than 90% of patients with adult intussusception have been reported to have an organic cause, with benign or malignant tumors for accounting for approximately 65% of the cases. In general, the diagnosis is easily made by means of computed tomography (CT) or magnetic resonance (MR) imaging. The imaging appearance of a bowel-within-bowel configuration with or without contained fat and mesenteric vessels, is pathognomonic. As the intussusceptum enters into the intussuscipiens, the mesentery is carried forward and trapped between the overlapping layers of bowel. The twisting or severe constriction of the mesenteric vessels may result in vascular compromise with subsequent edematous thickening of the involved bowel. In these circumstances, ischemic necrosis may develop if timely intervention is not undertaken. Therefore, determination of the presence or absence of intestinal necrosis in intussusception is important in patient management. On CT, the presence of well-known diagnostic CT criteria for strangulated obstruction (especially severe engorgement or twisting of the mesenteric vessels) as well as evidence of loss of the layered pattern, accumulation of extraluminal fluid collection, and bowel perforation, may suggest the diagnosis of intestinal necrosis. CT and MR imaging are limited in determining the primary disease causing intussusception. However, CT and MR provide excellent pre-operative evaluation, including the possible extension and/or dissemination of a malignant tumor. CT and MR imaging may also be useful in suggesting the presence of vascular compromise

  4. Association between medication and intestinal intussusception in children: a case-crossover study.

    Science.gov (United States)

    Vega García, Lourdes; Fuentes-Leonarte, Virginia; Tenías, José María; Correcher Medina, Patricia; Arias Arias, Ángel; Román Ortiz, Carmen

    2015-04-01

    This study aimed to assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days). A case-crossover design was used. We selected cases of children admitted with a diagnosis of intussusception (International Classification of Diseases, Ninth Revision, 860) to the major hospitals in the city of Valencia, Spain, from 2006 to 2009. We then estimated the association between the episode of intussusception and the intake of prescription medication during the preceding 2, 7, and 15 days (case period) and for the same time window 1, 2, 3, and 4 months prior (control period). Data on previous drug administration were obtained from the Pharmaceutical Service Manager System. A total of 95 cases (65.3% boys and 34.7% girls) were selected; 76.6% were younger than the age of 2 years. The association between intussusception and prior drug use varied depending on the exposure window: 15-day odds ratio (OR), 1.45 (95% confidence interval [95% CI], 0.86-2.43); 7-day OR, 1.46 (95% CI, 0.80-2.67); and 2-day OR, 2.26 (95% CI, 1.10-4.64). These associations were greater for children aged younger than 2 years and were usually due to the recent administration (preceding 2 days) of antibiotics (OR, 8.00; 95% CI, 1.47-43.7). Intussusception was more common among boys aged younger than 2 years. A positive and significant association was observed when drugs were administered 2 to 7 days before the onset of symptoms in children younger than the age of 2 years.

  5. Sonographic Findings of Pediatric Intussusception : Comparison between the Reduced and Non-reduced Group

    International Nuclear Information System (INIS)

    Park, Young Jin; Cha, Soon Joo; Jung, Seong Eun; Kim, Soo Young; Kim, Yong Hoon; Hur, Gam; Lee, Myeung Joon

    1996-01-01

    To determine the negative predictive findings of ultrasonography in intussusception reduction, we compared the ultrasonographic findings in reduced and non-reduced groups in pediatric intussusception. A retrospective evaluation of the 35 non-reduced and 73 reduced cases of intussuception was performed. The diagnosis was made initially by ultrasonography and confirmed by barium enema using gastrografin between 1993 and 1995. Ultrasonographic findings included thickness of outer colonic wall of the intussusception, diameter of the target, number of the lymph nodes, associated ascites and relapsed time after onset of symptoms. The thickness of the outer wall of the intussuception were 4.0∼9.5 mm (mean : 6.08 ± 1.04) in reduced group and 5.3∼11.6 mm (mean : 7.55 ± 1.16) in non-reduced group (p 0.05). Lymph adenopathy was seen in 65 (89%) cases in reduced group and 31 (89%) cases in non-reduced group, and average number of lymph nodes were 1.46 and 1.58 respectively. Ascites was seen in 9 (12.3%) cases of reduced and 12(34.3%) in non-reduced group (p < 0.05). The onset of symptoms presented 24 hours or longer prior to the diagnosis was 17 (23.3%) in reduced group and 17 (48.6%) in non-reduced group (p < 0.05). 7.55 mm or greater outer wall of the intussusception and associated ascites seen in ultrasonography, and the onset of symptoms 24 hours or longer prior to study can be used in negative predictive findings in intussusception reduction

  6. Sexual Function after Non-Nerve-Sparing Radical Cystoprostatectomy: A Comparison between Ileal Conduit Urinary Diversion and Orthotopic Ileal Neobladder Substitution

    Directory of Open Access Journals (Sweden)

    M.A Asgari

    2013-07-01

    Full Text Available Objective To compare the erectile function (EF and sexual desire (SD in men after radical cystoprostatectomy (RCP who had either an ileal conduit urinary diversion or orthotropic ileal neobladder substitution. Materials and Methods Eighty one sexually active men with bladder cancer were enrolled in this prospective study. After RCP according to patients' preferences they underwent either ileal conduit urinary diversion (n = 41 or orthotropic ileal neobladder substitution (n = 40. EF and SD were assessed using International Index of Erectile Function (IIEF questionnaire. Patients were assessed at 4-week before surgery and were followed up at 1, 6, and 12-month postoperatively using the same questionnaire. Results Postoperatively the EF and SD domains deteriorated significantly in both groups, but in a small proportion of the patients submitted to ileal neobladder they gradually improved with time (P = 0.006. At 12-month postoperative period, 4 (9.8% and 14 (35.0% patients in ileal conduit and ileal neobladder groups were able to achieve erections hard enough for vaginal penetration and maintained their erection to completion of intercourse, respectively (P = 0.006. Among patients in the ileal conduit and ileal neobladder groups, additional 4 (9.8% and 7 (17.1% patients were able to get some erection, but were unable to maintain their erection to completion of intercourse (P = 0.02. At 12-month follow up period 24.4% of the ileal conduit and 45.0% of the ileal neobladder patients rated their sexual desire very high or high (P = 0.01. Conclusion When performed properly, orthotopic ileal neobladder substitution after RCP offers better long-term results in terms of EF and SD.

  7. Metastatic osteosarcoma to the small bowel with resultant intussusception: a case report and review of the literature

    International Nuclear Information System (INIS)

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; West, Danel C.

    2003-01-01

    Intussusception resulting from osteosarcoma metastasis to the small bowel is a rare diagnosis. This case report describes a patient with this diagnosis, demonstrates the CT appearance of this lesion, and reviews the literature. (orig.)

  8. Intestinal obstruction due to ileal metastasis of Ewing's sarcoma

    African Journals Online (AJOL)

    in the 7–8-cm segment of the ileum as a source of bowel obstruction (Fig. 2a and b). There were prominent macroscopic features in the tumoral ileal segment such as subserosal hematoma and ischemic changes. There was notable tumoral involvement in the mesen- teric lymph nodes adjacent to the invasive bowel.

  9. Typhoid ileal perforation in children in Benin city | Osifo | African ...

    African Journals Online (AJOL)

    Background: Typhoid ileal perforation is a common complication of typhoid fever, a multi-systemic infection, which is endemic in many developing countries. Objective: This study reviews and compares the incidence, morbidity and mortality at the University of Benin Teaching Hospital with other referral centres located in ...

  10. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    OpenAIRE

    Krasniqi, Avdyl S; Hamza, Astrit R; Salihu, Lulzim M; Spahija, Gazmend S; Bicaj, Besnik X; Krasniqi, Selvete A; Kurshumliu, Fisnik I; Gashi-Luci, Lumturije H

    2011-01-01

    Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdom...

  11. Estimation of the endogenous N proportions in ileal digesta and faeces in 15N-labelled pigs

    International Nuclear Information System (INIS)

    Simon, O.; Bergner, H.

    1987-01-01

    4 castrated male pigs 40 kg fitted with simple 'T' cannulas in the terminal ileum were given 15 N-labelled ammonium salts, added to a low protein diet, for 6 days. Excretion of 15 N in urine and feces was monitored daily throughout the labelling and subsequent experimental periods. During the experimental period the pigs were given a diet based on wheat and fish meal, supplemented with varying levels of partially hydrolyzed straw meal to give crude fiber contents ranging from 40 to 132 g/kg. After adaptation to the particular levels of straw meal, feces and ileal digesta were collected during successive 24 h periods. N digestibility values were determined by the chromium oxide ratio method. The retention of 15 N-labelled non-specific N was 0.46 of the dose given. The validity of using urine values as a measure of 15 N abundance in endogenous N was demonstrated by the similarity of 15 N abundance in urine immediately before slaughter at the end of the experiment and in the digestive secretory organs thereafter. The average amount of endogenous N passing the terminal ileum was 3.4 g/day or 0.30-0.50 of total ileal N flow. This was not affected by dietary fiber level. The proportion of fecal N which was of endogenous origin was similar to that in ileal digesta, suggesting similar utilization of endogenous and residual dietary N by hindgut bacteria. Half the endogenous N entering the large intestine was reabsorbed there. Increasing dietary crude fiber from 40 to 132 g/kg increased fecal endogenous N excretion from 1.3 to 2.0 g/animal and day. (author)

  12. Sleep and quality of life in people with ileal conduit.

    Science.gov (United States)

    Cavdar, Ikbal; Temiz, Zeynep; Ozbas, Ayfer; Can, Gulbeyaz; Tarhan, Fatih; Findik, Ummu Yildiz; Kutlu, Fatma Yasemin; Akyuz, Nuray

    2016-12-01

    The aim of this study was to determine the sleep quality and the association between sleep quality and quality of life in people with ileal conduit. A descriptive and cross-sectional design was adopted. The study sample comprised 111 people with ileal conduit operated on in urology clinics in a state hospital between January 2011 and May 2014. Six months after the operation, they were called by telephone to participate in the study. Data for the study were collected using a questionnaire form, the Pittsburgh Sleep Quality Index (PSQI) and the Stoma Quality of Life Scale (SQLS). The mean ± SD total PSQI score of the people with ileal conduit was 10.20 ± 2.95, mean total score of SQLS was 43.63 ± 7.21, mean Work/Social Function domain score was 37.27 ± 5.80 and mean Stoma Function domain score was 50.0 ± 12.56. The total sleep quality had a low degree of negative correlation with total SQLS score, a medium degree of negative correlation with Work/Social Function (r = -0.327, p  .001). People using a night drainage system had higher sleep quality. This study determined that quality of life and sleep deteriorate in people with ileal conduit. The quality of life decreases when the sleep quality is poor, and decreased quality of life affects quality of sleep in people with ileal conduit.

  13. Hemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral re fl ux.

    Science.gov (United States)

    Fujimura, Tetsuya; Minowada, Shigeru; Kishi, Hiroichi; Hamasaki, Kimihisa; Saito, Kiyoshi; Kitamura, Tadaichi

    2005-10-01

    A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral reflux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral reflux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection.

  14. Intussusception of the small bowel secondary to an enterolith from a jejunal diverticulum.

    Science.gov (United States)

    di Marco, Aimee N; Purkayastha, Sanjay; Zacharakis, Emmanouil

    2012-09-01

    We report a case of acute, small bowel obstruction secondary to intussusception caused by an enterolith from a jejunal diverticulum, in an elderly female with a history of chronic, intermittent abdominal pain. Diagnostic work-up of the patient included a computed tomographic (CT) scan which demonstrated the intussusception, but not the enterolith, which was characteristically radiolucent. A laparotomy was performed and the enterolith was found and delivered. A fistula between the gallbladder and small bowel was sought, but not found. Multiple diverticulae were found throughout the small bowel. Although small bowel diverticulosis is rare, it should be considered in the differential diagnosis of the acute abdomen and chronic abdominal pain, especially in those with known colonic diverticulosis, in whom this condition is more common.

  15. A rare case of primary lymphoma of the caecum presenting as intussusception

    Directory of Open Access Journals (Sweden)

    Leena Jayabackthan

    2013-01-01

    Full Text Available Mucosa associated lymphoid tissue (MALT lymphomas are rare neoplasms. They are most common in the stomach followed by small intestine and colon. The symptoms are nonspecific and generally do not present with intussusception. Here we report a rare clinical entity in which a 35-year-old female presented to the emergency with severe abdominal pain which was sudden in onset. History revealed that she had been having vague mild abdominal pain for 2 years. Ultrasonography showed ileocolic intussusception with hypoechoic lesion of 54 × 46 mm seen at the lead point. Emergency laparotomy with the right hemi-colectomy was done. The specimen was sent for histopathological examination which revealed a diagnosis of MALT lymphoma. Awareness of the varied clinical presentation helps in formulating the appropriate therapeutic strategy.

  16. Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.

    Science.gov (United States)

    Yang, Jia-Hua; Zhang, Min; Zhao, Zhi-Hua; Shu, Yu; Hong, Jun; Cao, Yi-Jun

    2015-02-21

    Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermittent, colicky abdominal pain, nausea, and vomiting for over 4 wk accompanied by a weight loss. A diagnosis of gastric intussusception was made by computed tomography. A Billroth II distal gastrectomy was then performed, and complete en bloc removal (R0 resection) was achieved. Pathology confirmed a gastric schwannoma through positive immunohistochemical staining for S-100 protein.

  17. INTUSSUSCEPTION IN A CASE OF PEUTZ JEGHER SYNDROME: A CASE REPORT

    OpenAIRE

    Manmadh Rao; Babji; Mahalakshmi D; Sankarao

    2015-01-01

    PeutzJegher syndrome is a rare disorder characterized by mucocutaneous melanin deposits over lips, oral mucosa, fingers and multiple hamartomatous polyps in gastrointestinal tract. These individuals may present with small intestinal intussusception with th ese polyp as lead point. We report a case of 15 year old boy presenting with intestinal obstruction with oral melanin deposits and found to have multiple hamartomatous polyps in small intestine

  18. Intussusception reduction: Effect of air vs. liquid enema on radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan, Summer L.; Edgar, J.C.; Anupindi, Sudha A.; Zhu, Xiaowei [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA (United States); Magill, Dennise; Felice, Marc A. [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States)

    2017-10-15

    Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy.cm{sup 2}, than for liquid, 3.5 ± 2.5 dGy.cm{sup 2} (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy.cm{sup 2}/min, than for liquid, 1.4 ± 0.5 dGy.cm{sup 2}/min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction. (orig.)

  19. Metastatic melanoma causing double small intestinal intussusception: diagnosis by computed tomography

    International Nuclear Information System (INIS)

    Bortolucci, G.; Garcia, M.; Dalcim, L.; Dias, I.; Teshirogi, E.

    2011-01-01

    Full text: Introduction: Metastases from malignant melanoma to the gastrointestinal tract are uncommon. Often found in jejunum and ileum, they are responsible for up to 7% of complications pre mortem. These metastases manifest with bleeding, perforation, obstruction or intussusception and require immediate surgery. Intussusception is a rare finding in the report described and is presented in a double into distinct segments. History and Physical Examination: M.H.C.S, female, 50 years, presenting 3 cm ulcerated lesion in the calcaneous region of the right foot with two years of evolution, no signs of infection or neoplastic permeation shores. Surgical excision of the lesion was performed and histopathologic analysis showed non-classifiable malignant melanoma. Submitted material to immunohistochemistry showed that markers of antigens Melan A and HMB45 positive, favoring the diagnosis of malignant melanoma. Tumor resection with expanding margins and selective inguinal lymphadenectomy through the technique of sentinel node, with rates equal to V Clark and Breslow thickness of 1.3 cm. Patient presented with acute abdominal obstruction treated surgically. Despite an uneventful post-operative, brain metastases developed, and patient is currently undergoing chemotherapy. Complementary Exams: Contrasted abdominal CT showing distension of the small bowel and an image suggestive of double intussusception. Treatment and Results: Indicated that laparotomy confirmed the presence of double intussusception in small intestine, the first being 110 cm from the angle of Treitz with a palpable tumor mass and dilatation of the upstream and the second character equal to 220 cm of the same, treated with bowel resection followed by end anastomosis. The diagnosis of malignant melanoma was confirmed by immunohistochemical analysis of surgical specimens. Discussion/Conclusion: Metastatic lesions in the gastrointestinal tract are often asymptomatic or nonspecific. The diagnosis should be

  20. External resection of a giant sigmoid lipoma causing colonic intussusception and prolapse through the anal canal.

    Science.gov (United States)

    Tony, Jose; Saji, Sebastian; Sandesh, K; Sunilkumar, K; Ramachandran, T M; Thomas, Varghese

    2007-01-01

    We depict the case of an 80-year-old female patient who presented to us with a history of protruding mass per anum. Sigmoidoscopy revealed a large globular pedunculated polyp at 22 cm from the anal verge resulting in a sigmoidorectal intussusception. Endoscopic polypectomy was not technically possible due to the large size of the polyp. At the time of prolapse the polyp was tied at its pedicle with thread and resected surgically. The patient is asymptomatic on follow-up.

  1. Intussusception reduction: Effect of air vs. liquid enema on radiation dose

    International Nuclear Information System (INIS)

    Kaplan, Summer L.; Edgar, J.C.; Anupindi, Sudha A.; Zhu, Xiaowei; Magill, Dennise; Felice, Marc A.

    2017-01-01

    Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy.cm 2 , than for liquid, 3.5 ± 2.5 dGy.cm 2 (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy.cm 2 /min, than for liquid, 1.4 ± 0.5 dGy.cm 2 /min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction. (orig.)

  2. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

    Directory of Open Access Journals (Sweden)

    Yaw Boateng Mensah

    2011-01-01

    Full Text Available Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months. Twelve (67% of the cases were reduced successfully while 6 (33% failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7% cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

  3. Adult suprapatellar pleiomorphic rhabdomyosarcoma with jejunal metastasis causing intussusception : a case report

    OpenAIRE

    Gys, Ben; Peeters, Dieter; Driessen, Ann; Snoeckx, Annemie; Komen, Niels

    2016-01-01

    Abstract: Jejuno-jejunal intussusception is rarely encountered in adults. Management depends on the viability of the involved bowel. Exploration is favored because in adults generally an underlying `lead point' is found to be present. Pleimorphic rhabdomyosarcoma (pRMS) arises from striated muscle cells. They are usually diagnosed during childhood and can occur virtually all over the body, controversially in places were few striated cells are found. In adults, these tumors are rare and are mo...

  4. Technique and outcomes of bladder neck intussusception during robot-assisted laparoscopic prostatectomy: A parallel comparative trial.

    Science.gov (United States)

    Tan, Hung-Jui; Xiong, Siwei; Laviana, Aaron A; Chuang, Ryan J; Treat, Eric; Walsh, Patrick C; Hu, Jim C

    2016-12-01

    Postprostatectomy incontinence significantly impairs quality of life. Although bladder neck intussusception has been reported to accelerate urinary recovery after open radical retropubic prostatectomy, its adaption to robotic surgery has not been assessed. Accordingly, we describe our technique and compare outcomes between men treated with and without bladder neck intussusception during robot-assisted laparoscopic prostatectomy. We performed a comparative trial of 48 men undergoing robot-assisted laparoscopic prostatectomy alternating between bladder neck intussusception (n = 24) and nonintussusception (n = 24). Intussusception was completed using 3-0 polyglycolic acid horizontal mattress sutures anterior and posterior to the bladder neck. We assessed baseline characteristics and clinicopathologic outcomes. Adjusting for age, body mass index, race, and D׳Amico risk classification, we prospectively compared urinary function at 2 days, 2 weeks, 2 months, and last follow-up using the urinary domain of the Expanded Prostate Cancer Index-Short Form. Baseline patient characteristics and clinicopathologic outcomes were similar between treatment groups (P>0.05). Median catheter duration (8 vs. 8d, P = 0.125) and rates of major postoperative complications (4.2% vs. 4.2%, P = 1.000) did not differ. In adjusted analyses, Expanded Prostate Cancer Index-Short Form urinary scores were significantly higher for the intussusception arm at 2 weeks (65.4 vs. 46.6, P = 0.019) before converging at 2 months (69.1 vs. 68.3, P = 0.929) after catheter removal and at last follow-up (median = 7mo, 80.5 vs. 77.0; P = 0.665). Bladder neck intussusception during robot-assisted laparoscopic prostatectomy is feasible and safe. Although the long-term effects appear limited, intussusception may improve urinary function during the early recovery period. Copyright © 2016. Published by Elsevier Inc.

  5. Ileal transposition in surgical treatment for type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Oleg Viktorovich Kornyushin

    2015-03-01

    Full Text Available High prevalence and insufficient efficacy of medical treatment in type 2 diabetes mellitus (T2DM poses a major challenge for medical care. Generally, only 30% of patients reach therapeutic goals, while remission occurs only in the minority of patients. In the obese (BMI>35 kg/m2, bariatric surgery provides an alternative to pharmacological treatment of T2DM, boosting remission/compensation rate up to 76.8%. A few recent clinical studies explored the anti-diabetic effect of ileal transposition (IT. This type of surgery targets restoration of incretin balance by proximal transposition of ileal segment. In this review, we discuss the salutary mechanisms of IT in T2DM based on the analysis of the pioneering clinical trials.

  6. Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration.

    Science.gov (United States)

    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

    2009-04-01

    A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment.

  7. Ileal microbiota composition of broilers fed various commercial diet compositions.

    Science.gov (United States)

    van der Hoeven-Hangoor, E; van der Vossen, J M B M; Schuren, F H J; Verstegen, M W A; de Oliveira, J E; Montijn, R C; Hendriks, W H

    2013-10-01

    Microbiota plays a role in the release and absorption of nutrients from feed components, thereby affecting digesta composition and moisture content of the excreta. The objective of the current study was to determine the effects of 5 different diets varying in ingredients (medium-chain fatty acids, nonstarch polysaccharides, and starch) on the microbiota composition of ileal digesta of broiler chickens and excreta DM content. Each treatment was repeated 6 times in cages each containing 18 Ross 308 broilers, with growth performance measured from 0 to 34 d of age and excreta DM and ileal microbiota composition analyzed at 34 d of age. Microbiota composition was evaluated using a novel ribosomal RNA microarray technology containing 370 different probes covering various genera, groups of microbial species, and individual species of the chicken gut microbiota, of which 321 had a signal above the background threshold. Replacing part of the animal fat and soybean oil in the wheat-based diet with medium-chain fatty acids (MCFA; 0.3% C10 and 2.7% C12) improved feed efficiency compared with the other dietary treatments. This coincided with a suppression of gram-positive bacteria belonging to the phylum of the Firmicutes, including Lactobacillus species, and species belonging to the family of the Enterococcaceae and Micrococcaceae, whereas the gram-negative bacteria belonging to the family of the Enterobacteriaceae were promoted. None of the other diets used in the present study notably changed the ileal digesta bacteria composition. Excreta DM content was not affected by dietary treatment. The variation between individual birds per dietary treatment was more pronounced than variation caused by feed composition, with the exception of the digesta microbiota of the birds fed the MCFA diet. It is concluded that a diet with MCFA significantly changes the ileal microbiota composition, whereas the effect of the other diets on the composition of the microbiota and excreta DM content

  8. Tuberculosis after jejuno-ileal bypass for morbid obesity.

    OpenAIRE

    Werbin, N.

    1981-01-01

    A patient contracted tuberculosis after 2 operations for morbid obesity. The difficulty in diagnosis and treatment is described. Jejuno-ileal bypass is a non-physiological operation, with many reported complications and side effects. Following this short experience the author and his colleagues have now abandoned this operation. Patients suffering from malnutrition as a result of slimming operations should be carefully monitored for tuberculosis.

  9. A High Incidence of Intussusception Revealed by a Retrospective Hospital-Based Study in Nha Trang, Vietnam between 2009 and 2011

    Science.gov (United States)

    Tran, Lan Anh T.; Yoshida, Lay Myint; Nakagomi, Toyoko; Gauchan, Punita; Ariyoshi, Koya; Anh, Dang Duc; Nakagomi, Osamu; Thiem, Vu Dinh

    2013-01-01

    Rotavirus is a leading cause of severe diarrhea among children worldwide. Thus, the World Health Organization recommended including rotavirus vaccines in national immunization programs. One concern about rotavirus vaccine, however, is a possible association with intussusception. Thus, it is crucial to know the baseline incidence of intussusception in the first year of life. A study conducted in Hanoi, Vietnam showed that the incidence of intussusception was the highest in the world. This retrospective cross-sectional study was undertaken to determine the incidence of intussusception among children Khanh Hoa Provincial General Hospital where virtually all cases of intussusception occurring in the city were assumed to have been encountered. The incidence of intussusception among children <1 year of age was 296 per 100,000 person-years (95% confidence interval [CI]: 225–382), and that among children <5 years of age was 196 per 100,000 person-years (95% CI: 169–226), confirming the high incidence of intussusception in Vietnam. Nevertheless, there was no intussusception in the first three months of life. We therefore recommend that the first dose of any rotavirus vaccine be administered to infants between 6 and 12 weeks of age. PMID:24155653

  10. Endoglin inhibition leads to intussusceptive angiogenesis via activation of factors related to COUP-TFII signaling pathway.

    Directory of Open Access Journals (Sweden)

    Ruslan Hlushchuk

    Full Text Available Angiogenesis is a highly coordinated, extremely complex process orchestrated by multiple signaling molecules and blood flow conditions. While sprouting mode of angiogenesis is very well investigated, the molecular mechanisms underlying intussusception, the second mode of angiogenesis, remain largely unclear. In the current study two molecules involved in vascular growth and differentiation, namely endoglin (ENG/CD105 and chicken ovalbumin upstream promoter transcription factor II (COUP-TFII were examined to unravel their specific roles in angiogenesis. Down- respectively up-regulation of both molecules tightly correlates with intussusceptive microvascular growth. Upon ENG inhibition in chicken embryo model, formation of irregular capillary meshwork accompanied by increased expression of COUP-TFII could be observed. This dynamic expression pattern of ENG and COUP-TFII during vascular development and remodeling correlated with formation of pillars and progression of intussusceptive angiogenesis. Similar findings could be observed in mammalian model of acute rat Thy1.1 glomerulonephritis, which was induced by intravenous injection of anti-Thy1 antibody and has shown upregulation of COUP-TFII in initial phase of intussusception, while ENG expression was not disturbed compared to the controls but decreased over the time of pillar formation. In this study, we have shown that ENG inhibition and at the same time up-regulation of COUP-TFII expression promotes intussusceptive angiogenesis.

  11. Effects of corn gluten feed inclusion at graded levels in a corn-soybean diet on the ileal and fecal digestibility of growing pigs

    Science.gov (United States)

    2014-01-01

    Background This study aimed to determine the effect of the inclusion of corn gluten feed (CGF) on the apparent and standardized ileal digestibility of protein and amino acids and the apparent ileal and total tract digestibility of energy in growing pigs. The study was performed using 16 barrows (weight, 45.3 ± 4.5 kg) that were fitted with a T cannula at the terminal ileum. There were four treatments: a corn-soybean diet without CGF and three corn-soybean diets containing increasing levels of CGF (65, 130, and 195 g/kg). Data were analyzed according to a randomized complete block design, four blocks with four pigs each (one pig per treatment). The trend of the response (linear or quadratic) was determined using orthogonal contrasts, and when a linear effect was determined, a linear equation was obtained. Results The results showed that the inclusion up to 195 g/kg of CGF in the corn-soybean diet did not diminish the ileal digestibility (apparent and standardized) of protein and amino acids (P > 0.05), except that of phenylalanine, cystine, and proline. A linear decrease (P digestibility of phenylalanine (0.011 and 0.015 percentage units, respectively), cystine (0.048 and 0.043 percentage units, respectively), and proline (0.045 and 0.047 percentage units, respectively) was noted. Similarly, ileal digestibility of dry matter and energy were adversely affected (reduced by 0.028 and 0.025 percentage units, respectively, per gram of CGF increment in the diet). A significant (P digestibility with increase in CGF amount in the diet was observed for energy (0.027 percentage units), dry matter (0.027 percentage units), crude protein (0.020 percentage units), and neutral detergent fiber (0.041 percentage units) per gram of CGF added to the diet. Conclusion CGF did not affect the ileal digestibility of protein and most amino acids but reduced the ileal and total tract digestibility of energy. PMID:25279142

  12. THE EFFECT OF BODY WEIGHT OF PIGS ON TRUE AND APPARENT ILEAL AMINO ACIDS DIGESTIBILITY OF RYE

    Directory of Open Access Journals (Sweden)

    Nitrayová

    2013-02-01

    Full Text Available It is generally accepted that the ability of pigs to digest protein increases with age. However, it has been shown that small pigs excreted more endogenous nitrogen (N than large pigs. Consequently, the apparent amino acids (AA digestibility may be lower in young pigs while true digestibility, which is corrected for endogenous losses, may be comparable with that found in older pigs. To test this hypothesis, six cannulated piglets (mean body weight 20.6 kg fitted with a simple T-cannula at terminal ileum were used to estimate apparent and true digestibilities of AA and of total N in a rye-based diet (96 % rye. The digestibility study was repeated on the same pigs fed the same diet when they reached mean body weight 61.7 kg. The apparent ileal digestibilities of total AA and total N were significantly higher in heavier pigs than in piglets. Except for methionine and phenylalanine, the apparent digestibilities of individual AA showed a similar pattern. In contrast, there was no significant difference between piglets and heavier pigs for the true ileal digestibility of total N. True digestibility of most AA was lower in heavier pigs than in piglets, the differences for total and some individual AA being significant. The present results suggest that the higher apparent digestibility values found in heavier pigs as compared to piglets are due to the confounding effect of endogenous N losses rather than the better ability of older pigs to digest protein.

  13. Twin studies reveal specific imbalances in the mucosa-associated microbiota of patients with ileal Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Willing, B.; Halfvarson, J.; Dicksved, J.; Rosenquist, M.; Jarnerot, G.; Engstrand, L.; Tysk, C.; Jansson, J. K

    2008-08-15

    Large inter-individual variation in the composition of the intestinal microbiota between unrelated individuals has made it challenging to identify specific aspects of dysbiosis that lead to Crohn's disease. To reduce variations in exposure during establishment of the gut flora and influence of genotype, we studied the mucosaassociated microbiota of monozygotic twin pairs that were discordant (n=6) or concordant (n=4) for Crohn's disease. DNA was extracted from biopsies collected from 5 locations between the ileum and rectum. Bacterial 16S ribosomal RNA genes were amplified and community composition assessed by terminal-restriction fragment length polymorphism, cloning and sequencing and quantitative real-time PCR. The microbial compositions at all biopsy locations for each individual were similar, regardless of disease state, but there were differences between individuals. In particular, individuals with predominantly ileal Crohn's had a dramatically lower abundance (P<0.001) of Faecalibacterium prausnitzii and increased abundance (P<0.03) of Escherichia coli compared to healthy co-twins and those with Crohn's localized in the colon. This dysbiosis was significantly correlated to the disease phenotype rather than genotype. The reduced abundance of F. prausnitzii and increased abundance of E. coli are indicative of an ileal Crohn's disease phenotype, distinct from colonic Crohn's disease and the relative abundances of these specific bacterial populations are promising biomarker candidates for differential diagnosis of Crohn's and eventually customized treatment.

  14. Acute enteritis or gastroenteritis in young dogs as a predisposing factor for intestinal intussusception: a retrospective study.

    Science.gov (United States)

    Rallis, T S; Papazoglou, L G; Adamama-Moraitou, K K; Prassinos, N N

    2000-10-01

    Various types of intestinal intussusception were diagnosed in 29 of 220 young dogs with acute enteritis or gastroenteritis, due to canine parvovirus (85 cases) or presumably to other infectious agents, inflammation or less common hypermotility and metabolic derangements (135 cases). As the other causes of the disease were excluded, acute enteritis or gastroenteritis was considered to be the most likely predisposing factor for the intestinal intussusception. The most common type of intussusception was found to be the ileocolic. Of the 21 dogs that underwent surgical resection and anastomosis of the intestine, 18 dogs recovered completely and three died due to complications. The high survival rate was due to the effective pre-operative, surgical and post-operative therapy.

  15. Incidentally detected small intestine intussusception caused by primary small intenstine carcinoma on {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jong; Oh, So Won; Kim, Yu Kyeong [Dept. of Nuclear MedicineSeoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul (Korea, Republic of)

    2017-09-15

    Small intestine intussusception in adults is a rare condition mainly caused by primary or metastatic small intestine malignancy. Here, we present a 72-year-old male patient who was diagnosed with small intestine cancer that was presented as small intestine intussusception on hybrid {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). The patient was initially referred for an abnormality on a chest radiography and severe anemia. FDG PET/CT showed the lung lesion in the right upper lobe of lung as a high FDG uptake mass. Accidentally, FDG PET demonstrated another intense hypermetabolic intraluminal lesion in the small intestine accompanied with intussusception shown as a circumferential hypermetabolic wall. By pathologic examination, the patient was diagnosed as primary small intestine cancer with lung metastasis. This case highlights usefulness of hybrid FDG PET/CT to identify unexpected malignancy.

  16. Neonatal small intestinal zygomyocosis misdiagnosed as intussusception in a two-day-old child with a review of the literature.

    Science.gov (United States)

    Agrawal, Pallavi; Saikia, Uma; Ramanaathan, Subbaih; Samujh, Ram

    2013-12-01

    Neonatal mucormycosis is caused by fungi belonging to the class Zygomycetes. Clinically, it mimics necrotizing enterocolitis. We describe a case of 2-day-old baby who presented with abdominal distension and vomiting. A clinical diagnosis of intussusception was suspected. An exploratory laprotomy revealed gangrenous bowel wall and no intussusception or any gas-filled vesicles. Histological examination of the gangrenous segment showed transmural ischemic necrosis with fungal hyphae of zygomycosis. The baby is doing well postoperatively at a follow-up of 3 months. Hence, a high degree of clinical suspicion is important in neonates not responding to usual therapy or antibiotics.

  17. Definition of apparent, true, and standardized ileal digestibility of amino acids in pigs

    NARCIS (Netherlands)

    Stein, H.H.; Fuller, M.F.; Moughan, P.J.; Seve, B.; Mosenthin, R.; Jansman, A.J.M.; Fernandez, J.A.; Lange, de C.F.M.

    2007-01-01

    Measures of ileal digestibility (ID) are used routinely as estimates of amino acid (AA) bio-availability in pig feed ingredients. Values for ID may be expressed as apparent (AID), standardized (SID), or true (TID). Values for AID are calculated by deducting the total ileal outflow of AA (the sum of

  18. The effect of N-acetyl-L-cysteine on the viscosity of ileal neobladder mucus.

    NARCIS (Netherlands)

    Schrier, B.P.; Lichtendonk, W.J.; Witjes, J.A.

    2002-01-01

    N-acetyl-L-cysteine (NAC) proved to be an effective mucolytic in pulmonary secretions. Our goal was to investigate the in vitro effect of NAC on viscosity of ileal neobladder mucus. The urine of a patient with an ileal neobladder was collected during the first 7 days postoperatively and stored in a

  19. Bladder substitution by ileal neobladder for women with interstitial cystitis

    Directory of Open Access Journals (Sweden)

    Wachira Kochakarn

    2007-08-01

    Full Text Available OBJECTIVE: To report our experience with cystectomy and ileal neobladder for women with interstitial cystitis (IC. MATERIALS AND METHODS: Thirty-five female patients treated during 2000-2005 with the mean age of 45.9 ± 4.4 years were included in this study. All of them had experience suprapubic pain with irritative voiding symptoms and were diagnosed as having IC based on NIDDK criteria for at least 2 years. Conservative treatments had failed to relieve their symptoms; and therefore all of them agreed to undergo a bladder removal. For cystectomy, the urethra was cut 0.5 cm below the bladder neck, proximal to the pubourethral ligament, leaving the endopelvic fascia intact. An ileal segment of 65 cm was used to create the neobladder with the Studer's technique. RESULTS: All patients presented good treatment outcome with regard to both diurnal and nocturnal urinary control without any pain. Quality of life using the SF-36 questionnaire showed significant improvement of both physical health and mental health. Spontaneous voiding with minimal residual urine was found in 33 cases (94.3%, and the remaining 2 cases (5.7% had spontaneous voiding with residual urine and were placed on clean intermittent catheterization (CIC. Twelve out of 30 cases with sexually active ability had a mild degree of dyspareunia but without disturbance to sexual life. CONCLUSION: Bladder substitution by ileal neobladder for women who suffer from IC can be a satisfactory option after failure of conservative treatment. Resection of the urethra distal to the bladder neck can preserve continence and allow spontaneous voiding in almost all patients.

  20. Malignancy risk prediction for primary jejunum-ileal tumors

    Directory of Open Access Journals (Sweden)

    MARQUES Ruy Garcia

    2000-01-01

    Full Text Available This work is aimed at identifying factors associated with primary jejunum-ileal tumors malignancy, defining a prediction model with sensitivity, specificity and accuracy to distinguish malign from benign neoplasms. These tumors are rare, have highly unspecific presentation and, frequently, are diagnosed late. We reviewed the charts of 42 patients with primary jejunum-ileal tumors treated in the Department of General Surgery of Rio de Janeiro State University Hospital, Rio de Janeiro, RJ, Brazil, from 1969 to 1998. We performed bivariate analyses, based on chi² test, searching associations between tumors malignancy and demographic and clinical variables. Then logistic regression was employed to consider the independent effect of variables previously identified on malignancy risk. The malign tumors included 11 adenocarcinomas, 7 leiomyosarcomas, 5 carcinoids and 4 lymphomas; the benign tumors included 10 leiomyomas, 2 hamartomas, and single cases of adenoma, multiple neurilemoma and choristoma. The bivariate analyses indicated the association between malignancy and palpable abdominal mass (P = 0.003, period from signs and symptoms onset to diagnosis (P = 0.016, anemia (P = 0.020, anorexia (P = 0.003, abdominal pain (P = 0.031, weight loss (P = 0.001, nausea and vomit (P = 0.094, and intestinal obstruction (P = 0.066; no association with patients demographic characteristics were found. In the final logistic regression model, weight loss, anemia and intestinal obstruction were statistically associated with the dependent variable of interest. Based only on three variables -- weight loss, anemia and intestinal obstruction -- the model defined was able to predict primary jejunum-ileal tumors malignancy with sensitivity of 85.2%, specificity of 80.0%, and accuracy of 83.3%.

  1. Ileal J-pouch vaginoplasty: reconstruction of a physiologic vagina with an ileal J-pouch.

    Science.gov (United States)

    Schneider, Wolfgang; Nguyen-Thanh, Phuong; Dralle, Henning; Mirastschijski, Ursula

    2009-06-01

    Vaginal reconstruction has been performed for more than a century. Main complications are vaginal stenosis requiring dilatation, dyspareunia, excessive mucus secretion, and poor aesthetic and functional outcome. Here we report a new operation method modified after Baldwin for intestinal vaginoplasty in a patient with pelvic exenteration after spinal cell carcinoma of the vagina. Because of balanced liquid resorption and mucus secretion with sufficient vessel length in the terminal ileum, this intestinal segment was chosen. A J-pouch of distal ileum was constructed pedicled on the ileocolic artery and accompanying nervous plexus, transferred into the lower pelvis and sutured to the vaginal stump. One year follow-up showed a highly satisfied, sexually active patient, with adequate vaginal size, optimal lubrication and no molesting fecal odor. Terminal ileum J-pouch vaginoplasty is an optimal method for vaginal reconstruction providing a sufficient vaginal lumen and lubrication and thereby restoring patients' sexual life and increasing life quality.

  2. Percutaneous transhepatic obliteration of stomal variceal hemorrhage from an ileal conduct: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seung Hyun; Lee, Shin Jae; Won, Jong Yun; Park, Sung Il; Lee, Do Yun; Kim, Man Deuk [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Do Young [Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Variceal bleeding is an unusual complication of ileal conduits. We report a case in which recurrent stomal variceal hemorrhage from an ileal conduit for bladder cancer was successfully treated by percutaneous transhepatic obliteration (PTO) using microcoils and N-butyl cyanoacrylate. Therefore, PTO can be one treatment option to prevent recurrent stomal variceal bleeding from ileal conduits.

  3. Pulmonary and Ileal Tuberculosis Presenting as Fever of Undetermined Origin

    Science.gov (United States)

    Surewad, Gajanan; Lobo, Ivona

    2014-01-01

    A 12-year-old girl presented with prolonged fever with no obvious focus on either history or clinical examination. High-resolution computerized tomography of the chest revealed the ‘tree-in-bud’ sign in the right lung and necrotic mediastinal lymph nodes. Barium meal showed multiple ileal strictures. The child was treated with anti-tuberculous therapy for six months. At follow-up six months later, the child had gained weight and had no signs of intestinal obstruction. Tuberculosis is a common cause of fever of undetermined origin and should be investigated for especially in countries with a high prevalence. PMID:25478420

  4. Intussusception in a term newborn with duct-dependent congenital heart disease

    Directory of Open Access Journals (Sweden)

    Banu Aydın

    2013-03-01

    Full Text Available Prostaglandin E1 infusion is widely used to maintain patencyof ductus arteriosus in newborns with duct-dependentcongenital heart disease until surgery. ProstaglandinE1 is a lifesaving drug, but it has many side effects includingfever, apnea, bradycardia, hypotension, convulsion,edema, and cortical hyperostosis. The gastrointestinaltract has not been recognized as a major site of seriousadverse effects of prostaglandin E1 infusion, althoughdiarrhea is a well-recognized side effect that usually respondsto dose reduction. In this report, we present acase of intestinal intussusception presumably induced byprostaglandin therapy in a newborn with duct-dependentcongenital heart disease.Key words: Prostaglandin E1, newborn, gastrointestinal

  5. Stent intussusception after thromboaspiration through a platinum chrome stent: a particular case of longitudinal stent deformation.

    Science.gov (United States)

    Mila, Rafael; Vignolo, Gustavo; Trujillo, Pedro

    2015-04-01

    The need to improve stent deliverability has led to the development of thinner and more flexible stents. However, there is concern about decreased longitudinal strength. The number of longitudinal stent deformation reports has dramatically increased. We report a case of stent longitudinal deformation after thromboaspiration through a new generation platinum chrome bare metal stent. Images show an "intussusception effect," an extreme form of the previously described "concertina deformation," as the mechanism of shortening. Since stent technology is constantly evolving, newer devices will probably be designed to have less susceptibility to longitudinal stent deformation.

  6. Sonographic Evaluation and Monitoring of Pneumoperitoneum After Air Enema Reduction for Intussusception.

    Science.gov (United States)

    Zhou, Amy Z; Toporowski, Amy; Tsung, James W

    2018-02-12

    Abdominal radiography and computed tomography scans are standard tests to diagnose pneumoperitoneum. With the growing availability of point-of-care ultrasound, pneumoperitoneum may be diagnosed in settings without easy access to radiography or computed tomography, such as in overcrowded emergency departments or resource-poor environments. The use of point-of-care ultrasound to diagnose or monitor pneumoperitoneum has been described in adult but not pediatric patients. We present a case of point-of-care ultrasound detection of pneumoperitoneum and monitoring for tension pneumoperitoneum, after failed air enema reduction for intussusception in an infant.

  7. Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect

    Directory of Open Access Journals (Sweden)

    V. Insinga

    2014-06-01

    Full Text Available Intestinal atresia type III B (apple peel and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

  8. Jejuno–ileal diverticulitis: Etiopathogenicity, diagnosis and management

    Science.gov (United States)

    Kassir, Radwan; Boueil-Bourlier, Alexia; Baccot, Sylviane; Abboud, Karine; Dubois, Joelle; Petcu, Carmen Adina; Boutet, Claire; Chevalier, Ugo; Montveneur, Mathias; Cano, Marie-Isabelle; Ferreira, Romain; Debs, Tarek; Tiffet, Olivier

    2015-01-01

    Introduction Although diverticular disease of the duodenum and colon is frequent, the jejuno–ileal diverticulosis (JOD) is an uncommon entity. The perforation of the small bowel diverticula can be fatal due to the delay in diagnosis. Presentation of case We report the case of a 79-year-old man presenting with generalized abdominal pain and altered bowel habits. Physical examination revealed a severe diffuse abdominal pain. A CT scan of the abdomen and pelvis with oral contrast showed thickening of the distal jejunal loop and thickening and infiltration of the mesenteric fat and the presence of free air in the mesentery suggesting a possible perforation adjacent to the diverticula. A midline laparotomy was performed. The jejunal diverticula were found along the mesenteric border. Forty centimeters of the jejunum were resected. Histopathology report confirmed the presence of multiple jejunual diverticula, and one of them was perforated. The patient tolerated the procedure and the postoperative period was uncomplicated. Discussion The prevalence of small intestinal diverticula ranges from 0.06% to 1.3%. The etiopathogenesis of JOD is unclear, although the current hypothesis focuses on abnormalities in the smooth muscle or myenteric plexus, on intestinal dyskinesis and on high intraluminal pressures. Diagnosis is often difficult and delayed because clinical symptoms are not specific and mainly imaging studies performs the diagnosis. Conclusion Because of the relative rarity of acquired jejuno–ileal diverticulosis, the perforation of small bowel diverticulitis poses technical dilemmas. PMID:25841158

  9. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review.

    Science.gov (United States)

    Takahashi, Toshiaki; Miyano, Go; Kayano, Hajime; Lane, Geoffrey J; Arakawa, Atsushi; Yamataka, Atsuyuki

    2014-01-01

    Colo-colonic intussusception (CI) due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR) and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  10. A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Toshiaki Takahashi

    2014-01-01

    Full Text Available Colo-colonic intussusception (CI due to a colonic polyp is a rarely reported cause of intestinal obstruction in school-aged children. Hydrostatic reduction (HR and endoscopic polypectomy are minimally invasive and technically feasible for treating CI. We report a case of CI and review the literature, focusing on the diagnosis and treatment.

  11. Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

    Directory of Open Access Journals (Sweden)

    Bicaj Besnik X

    2011-09-01

    Full Text Available Abstract Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications.

  12. Acute pancreatitis secondary to duodeno-duodenal intussusception caused by a duodenal membrane, in a patient with intestinal malrotation

    DEFF Research Database (Denmark)

    Larsen, Pernille Oehlenschläger; Pedersen, Mark Ellebæk; Kjærulf Pless, Torsten

    2015-01-01

    Duodeno-duodenal intussusception is often caused by an intraluminal tumour. The condition is rare owing to the retroperitoneal fixation of the duodenum, which is sometime absent in cases of intestinal malrotation. We describe the case of a 19-year old man admitted to hospital with abdominal pain ...

  13. Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

    Science.gov (United States)

    Sabater, Mikel; Huynh, Minh; Forbes, Neil

    2015-03-01

    A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

  14. Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction.

    Science.gov (United States)

    Raval, Mehul V; Minneci, Peter C; Deans, Katherine J; Kurtovic, Kelli J; Dietrich, Ann; Bates, D Gregory; Rangel, Shawn J; Moss, R Lawrence; Kenney, Brian D

    2015-11-01

    The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center. A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge. Patient outcomes were tracked, and quarterly feedback was provided. Of 80 patients identified over a 24-month period, 34 (42.5%) did not qualify for discharge home due to need for surgical intervention (n = 9), specific radiologic findings (n = 11), need for additional intravenous hydration (n = 4), or other reasons (n = 7). Of 46 patients who qualified for discharge, 30 (65.2%) were successfully sent home from the ED. One patient returned with recurrent symptoms that required repeat enema reduction. Sixteen patients were observed and discharged within 23 hours. Adherence with discharge from the ED improved over time. Discharge from the ED was associated with cost savings and improved net margins at the hospital level for each encounter. A sustainable multidisciplinary quality improvement project to discharge intussusception patients from the ED after air-contrast enema reduction was successfully integrated in a high-volume referral center through education, standardized radiologic reporting, and protocoled follow-up. Copyright © 2015 by the American Academy of Pediatrics.

  15. ⁶⁸Ga-DOTA-TOC-PET/CT detects heart metastases from ileal neuroendocrine tumors.

    Science.gov (United States)

    Calissendorff, Jan; Sundin, Anders; Falhammar, Henrik

    2014-09-01

    Metastases from ileal neuroendocrine tumors (NETs) to the myocardium are rare and generally seen in patients with widespread metastatic NET disease. The objectives of this investigation were to describe the frequency of intracardiac metastases in ileal NET patients examined by (68)Ga-DOTA-TOC-PET/CT and to describe the cases in detail. All (68)Ga-DOTA-TOC-PET/CT examinations performed at the Karolinska University Hospital since 2010 until April 2012 were reviewed. In all, 128 out of 337 examinations were in patients with ileal NETs. Four patients had seven myocardiac metastases, yielding a frequency of 4.3 % in patients with ileal NETs. One patient had cardiac surgery while three were treated with somatostatin analogs. The cardiac metastases did not affect the patients' activity of daily life. (68)Ga-DOTA-TOC-PET/CT is an established imaging modality in identifying cardiac metastases in ileal NETs. Prospective studies are needed to confirm the true clinical value of (68)Ga-DOTA-TOC-PET/CT in detecting cardiac metastases in both ileal and non-ileal NETs.

  16. Comparative ileal amino acid digestibility of distillers' grains for growing pigs

    Directory of Open Access Journals (Sweden)

    Olayiwola Adeola

    2016-12-01

    Full Text Available The objective of the experiment reported here was to investigate and compare the amino acid (AA digestibility of distillers' dried grains (DDG, distillers' dried grains with solubles (DDGS, high protein distillers' dried grains (HP-DDG, and high protein distillers' dried grains with solubles (HP-DDGS in growing pigs. Five semi-purified diets consisting of DDG, DDGS, HP-DDG, HP-DDGS, and nitrogen-free diet (NFD were fed to pigs fitted with simple T-cannula for 5 observations per diet. Endogenous losses of AA at the terminal ileum of pigs that received the NFD were used to calculate standardized ileal digestibility (SID of AA from apparent ileal digestibility (AID of AA. The AID of Lys in DDGS was lower (P < 0.05 than that in DDG, which was also lower (P < 0.05 than that in HP-DDG. There were no differences in AID of Met among DDG, DDGS and HP-DDGS, but was greater (P < 0.05 in HP-DDG than in DDG or DDGS. The AID of Thr in HP-DDG was greater (P < 0.05 than that in DDGS but not different from that in DDG or HP-DDGS. The branched-chain AA Ile and Leu had greater (P < 0.05 AID in HP-DDG than in DDG, DDGS or HP-DDGS, and there was no difference among DDG, DDGS, and HP-DDGS. The AID of Trp in DDG and DDGS or HP-DDG and HP-DDGS were not different, but the AID of Trp in HP-DDGS was greater (P < 0.05 than that of DDGS. The greatest SID of the indispensable AA was in HP-DDG. Except for Arg and Lys in which DDG had greater (P < 0.05 digestibility, there was no difference between DDG and DDGS in the SID of the indispensable AA. The SID of Lys in DDG was greater (P < 0.05 than that of DDGS but there was no difference between that of DDG and HP-DDGS. Only His, Ile, and Met had lower (P < 0.05 SID in HP-DDGS than HP-DDG within the indispensable AA. The SID of Ala, Asp, Cys, Glu, Gly, Ser and Tyr were lower (P < 0.05 in DDGS than in HP-DDG. There SID of dispensable AA in DDG was not different from that of HP-DDGS. The current study provided

  17. Radiation dose in pneumatic reduction of ileo-colic intussusceptions - results from a single-institution study

    Energy Technology Data Exchange (ETDEWEB)

    Cullmann, Jennifer L.; Heverhagen, Johannes T.; Puig, Stefan [Inselspital, University Hospital Bern, Institute for Diagnostic, Interventional, and Pediatric Radiology, Bern (Switzerland)

    2015-05-01

    Air enema under fluoroscopy is a well-accepted procedure for the treatment of childhood intussusception. However, the reported radiation doses of pneumatic reduction with conventional fluoroscopy units have been high in decades past. To compare current radiation doses at our institution to past doses reported by others for fluoroscopic-guided pneumatic reduction of ileo-colic intussusception in children. Since 2007 radiologists and residents in our department who perform reduction of intussusceptions have received a radiation risk training. We retrospectively analyzed the data of 45 children (5 months-8 years) who underwent a total of 48 pneumatic reductions of ileo-colic intussusception between 2008 and 2012. We analyzed data for screening time and dose area product (DAP) and compared these data to those reported up to and including the year 2000. Our mean screening time measured by the DAP-meter was 53.8 s (range 1-320 s, median 33.0 s). The mean DAP was 11.4 cGy circle cm{sup 2} (range 1-145 cGy circle cm{sup 2}, median 5.45 cGy circle cm{sup 2}). There was one bowel perforation, in a 1-year-old boy requiring surgical revision. Only three studies in the literature presented radiation exposure results on children who received pneumatic or hydrostatic reduction of intussusception under fluoroscopy. Screening times and dose area products in those studies, which were published in the 1990s and in the year 2000, were substantially higher than those in our sample. Low-frequency pulsed fluoroscopy and other dose-saving keys as well as the radiation risk training might have helped to improve the quality of the procedure in terms of radiation exposure. (orig.)

  18. Inflammatory myofibroblastic tumor with ALK/TPM3 fusion presenting as ileocolic intussusception: an unusual presentation of an unusual neoplasm

    NARCIS (Netherlands)

    Milne, Anya N. A.; Sweeney, Karl J.; O'Riordain, Diarmuid S.; Pauwels, Patrick; Debiec-Rychter, Maria; Offerhaus, G. Johan A.; Jeffers, Michael

    2006-01-01

    Inflammatory myofibroblastic tumor is a rare spindle cell lesion of indeterminate malignant potential occurring in both pulmonary and extrapulmonary tissues. This report describes an unusual presentation of an unusual tumor at an unusual location: an intramural ileal case of inflammatory

  19. Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

    Science.gov (United States)

    Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

    2012-04-27

    Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged vaccine and intussusception. A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants vaccination in 2 of 27 patients who had received at least 1 dose of a rotavirus vaccine. Valuable data on the incidence, clinical presentation and treatment outcomes of intussusception can be obtained from data retrieved from hospital medical records in a sentinel paediatric hospital using standardised methodology. However, there are methodological limitations and the quality of the data is highly dependent on the accuracy and completeness of the patient information recorded, the system of coding and record retrieval. Copyright © 2011 Elsevier Ltd. All

  20. Intussusception due to Peutz-Jeghers syndrome - a case report and review of the literature; Sindrome de Peutz-Jeghers e intussuscepcao - relato de um caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Grasso Filho, Luiz Eduardo; Albertotti, Flavio; Carvalho, Claudio Sobral de; Nersessian, Ana Carolina; Docema, Marcos F. Lima; Ogasawara, Aparecida M.; Peng Yong Sheng [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico por Imagem; Costacurta, Marco Antonio [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Radiologia Geral; Albertotti, Cesar Jose [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada; Cerri, Giovanni Guido [Hospital Sirio Libanes, Sao Paulo, SP (Brazil). Servico de Ultra-Som

    2000-02-01

    The authors report a case of a 28-year-old woman with ileocecocolic intussusception due to Peutz-Jeghers syndrome, an autosomal dominant disorder characterized by hamartomatous polyposis of the gastrointestinal tract and mucocutaneous pigmentation. This condition frequently presents complications such as intestinal obstruction due to invagination or hemorrhage. In this patient, the diagnosis of intussusception was made preoperatively. The excised material revealed three large polyps which were considered to be the cause of the intussusception. (author)

  1. Impact of diet composition on ileal digestibility and small intestinal morphology in early-weaned pigs fitted with a T-cannula.

    Science.gov (United States)

    Kluess, J; Schoenhusen, U; Souffrant, W B; Jones, P H; Miller, B G

    2010-04-01

    Piglets, separated from their dam at 12 days of age and fed a milk substitute hourly, were used as a model for suckling. Animals were fitted with a terminal ileal T-cannula and a jugular vein catheter. At 28 days of age, half of the pigs had a dietary change to a cereal-based weaner diet fed as slurry, and the others remained on milk substitute. Animals were labelled by oral administration of 15N-labelled yeast for 10 days (days 15 to 25). Blood samples were taken twice a day to monitor 15N enrichment of the blood plasma. Diets included polyethylenglycol (PEG 4000) to allow calculation of apparent ileal digestibility of nitrogen and individual amino acids. Ileal bacterial nitrogen was calculated from D-alanine content of the digesta. Furthermore, small intestinal (SI) villus height and crypt depth were measured. Feed intake was increased by the dietary change. The total nitrogen flow was 3.2 ± 0.4 g/day and 5.9 ± 0.4 for the milk and weaner diet, respectively. Endogenous nitrogen flow at the terminal ileum was similar for both groups (milk diet 2.4 ± 0.4 v. weaner diet 2.2 ± 0.3 g/day), whereas the bacterial nitrogen content (0.08 ± 0.01 g/day milk diet v. 0.15 ± 0.01 g/day weaner diet, P diet v. 3.29 ± 0.12 g/day weaner diet, P diet group. The ileal apparent digestibility coefficient of protein was 0.81 ± 0.06 and 0.68 ± 0.01 for the milk replacer and the weaner diet, respectively. Morphology measurements made along the SI at 25%, 50% and 75% were similar between piglets fed milk replacer and those fed a cereal-based weaner diet. The only statistical effect (P diet group. In conclusion, pigs, following a dietary change analogous to weaning, lack the capacity to fully digest a standard weaner diet. This may result in an increased nutrient content entering the large intestine and an altered microbiota. In the absence of a period of anorexia, often associated with traditional weaning, we saw no evidence of villous atrophy, but report here a significant crypt

  2. Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature

    Directory of Open Access Journals (Sweden)

    Papastratis George

    2001-01-01

    Full Text Available Abstract Background Jejunogastric intussusception (JGI is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. Case presentation A young man presented with epigastric pain and bilous vomiting followed by hematemesis,10 years after vagotomy and gastrojejunostomy for a bleeding duodenal ulcer. Emergency endoscopy showed JGI and the CT scan of the abdomen was compatible with this diagnosis. At laparotomy a retrograde type II, JGI was confirmed and managed by reduction of JGI without intestinal resection. Postoperative recovery was uneventful. Conclusions JGI is a rare condition and less than 200 cases have been published since its first description in 1914. The clinical picture is almost diagnostic. Endoscopy performed by someone familiar with this rare entity is certainly diagnostic and CT-Scan of the abdomen could also help. There is no medical treatment for acute JGI and the correct treatment is surgical intervention as soon as possible.

  3. Idiopathic postoperative ileo-colic intussusception in an adult with rectal cancer

    Directory of Open Access Journals (Sweden)

    Marc Paul Jose Lopez

    2016-09-01

    Full Text Available A 39-year-old female presented with symptoms of complete gut obstruction caused by a locally advanced rectal malignancy. She underwent a mini-laparotomy and creation of a proximal transverse loop colostomy (TLC. No other points of obstruction were noted. Post-operatively, clinical and radiological evidence of gut obstruction prompted a re-exploration. This revealed an ileo-colic intussusception. A right hemicolectomy was performed. No identifiable lead point was documented. The patient later underwent long course chemoradiation to address the locally advanced tumor. She, eventually, had a low anterior resection. In this study, it was illustrated that prompt and vigilant detection of such rare occurrences allow for the institution of a management plan that maintains adherence to oncologic principles. [Arch Clin Exp Surg 2016; 5(3.000: 187-189

  4. Mantle Cell Lymphoma of Intestine Presenting as Multiple Lymphomatous Polyposis with Intussusception

    Directory of Open Access Journals (Sweden)

    Meena N. Jadhav

    2015-01-01

    Full Text Available Mantle Cell Lymphoma (MCL is a distinct clinicopathological subtype of B-cell non-Hodgkin's lymphoma (NHL accounting for 2-10% of all NHL cases. Gastrointestinal tract (GIT is the predominant site of extranodal MCL which commonly presents as Multiple Lymphomatous Polyposis (MLP. A 60 year old male presented with pain abdomen, diarrhea and weight loss of two months duration. On colonoscopy multiple polyps were found in the entire colon and rectum. Computed tomography revealed ileo-colic intussusception with nodularity in the lead point. Histopathology suggested features of MCL. On immunohistochemistry, the tumor cells were positive for CD20, CD5, Cyclin D1, negative for CD3, CD10, CD23, and CD45 RO

  5. Associations of Adenovirus Genotypes in Korean Acute Gastroenteritis Patients with Respiratory Symptoms and Intussusception

    Directory of Open Access Journals (Sweden)

    Jae-Seok Kim

    2017-01-01

    Full Text Available Human adenoviruses (HAdVs cause a wide range of diseases, including respiratory infections and gastroenteritis, and have more than 65 genotypes. To investigate the current genotypes of circulating HAdV strains, we performed molecular genotyping of HAdVs in the stool from patients with acute gastroenteritis and tried to determine their associations with clinical symptoms. From June 2014 to May 2016, 3,901 fecal samples were tested for an AdV antigen, and 254 samples (6.5% yielded positive results. Genotyping using PCR and sequencing of the capsid hexon gene was performed for 236 AdV antigen-positive fecal specimens. HAdV-41, of species F, was the most prevalent genotype (60.6%, followed by HAdV-2 of species C (13.8%. Other genotypes, including HAdV-3, HAdV-1, HAdV-5, HAdV-6, HAdV-31, HAdV-40, HAdV-12, and HAdV-55, were also detected. Overall, 119 patients (50.4% showed concomitant respiratory symptoms, and 32 patients (13.6% were diagnosed with intussusception. HAdV-1 and HAdV-31 were significantly associated with intussusception (P<0.05. Our results demonstrate the recent changes in trends of circulating AdV genotypes associated with gastroenteritis in Korea, which should be of value for improving the diagnosis and developing new detection, treatment, and prevention strategies for broad application in clinical laboratories.

  6. Species Level Description of the Human Ileal Bacterial Microbiota.

    Science.gov (United States)

    Villmones, Heidi Cecilie; Haug, Erik Skaaheim; Ulvestad, Elling; Grude, Nils; Stenstad, Tore; Halland, Adrian; Kommedal, Øyvind

    2018-03-16

    The small bowel is responsible for most of the body's nutritional uptake and for the development of intestinal and systemic tolerance towards microbes. Nevertheless, the human small bowel microbiota has remained poorly characterized, mainly owing to sampling difficulties. Sample collection directly from the distal ileum was performed during radical cystectomy with urinary diversion. Material from the ileal mucosa were analysed using massive parallel sequencing of the 16S rRNA gene. Samples from 27 Caucasian patients were included. In total 280 unique Operational Taxonomic Units were identified, whereof 229 could be assigned to a species or a species group. The most frequently detected bacteria belonged to the genera Streptococcus, Granulicatella, Actinomyces, Solobacterium, Rothia, Gemella and TM7(G-1). Among these, the most abundant species were typically streptococci within the mitis and sanguinis groups, Streptococcus salivarius, Rothia mucilaginosa and Actinomyces from the A. meyeri/odontolyticus group. The amounts of Proteobacteria and strict anaerobes were low. The microbiota of the distal part of the human ileum is oral-like and strikingly different from the colonic microbiota. Although our patient population is elderly and hospitalized with a high prevalence of chronic conditions, our results provide new and valuable insights into a lesser explored part of the human intestinal ecosystem.

  7. Terminal myelocystocele.

    Science.gov (United States)

    Kumar, Raj; Chandra, Anil

    2002-12-01

    Terminal myelocystocele is an unusual form of occult spinal dysraphism. It consists of a cystic dilatation of a low-lying terminal cord herniated posteriorly through a skin covered lumbosacral spina bifida. This condition is often associated with OEIS complex i.e. opmphalocele, exstrophy of the bladder, imperforate anus and spinal abnormality. We studied 4 cases of terminal myelocystocele. They revealed no preoperative neurological deficit. None of these had associated OEIS complex. One of the cyst was unique due to presence of copious amount of pus in its cavity. All four cases underwent successful repair and surgery remained uneventful in all of them. No child showed neurological deterioration during the follow-up.

  8. Value of imaging in intestinal intussusception in adults. Report of a case of ileocolic intussusception secondary to caecal lipoma; Apport de l`imagerie dans les invaginations intestinales de l`adulte. A propos d`un cas d`invagination ileo-colique, secondaire a un lipome caecal

    Energy Technology Data Exchange (ETDEWEB)

    Ferrokh, D.; Saadaoui, H.; Hainaux, B. [Universite Libre de Bruxelles (Belgium)

    1996-12-31

    On the basis of a case of ileocolic intussusception in a 35-years-old patient secondary to an obstructive lipoma of the caecum, the authors review the literature and discuss the clinical and radiological aspects of this disease. The diagnosis was established by CT scan and barium enema before surgery. Adult intussusception is a rare disease, which does not have any specific clinical features. Radiological imaging is the only complementary investigation which can suggest the diagnosis. (author)

  9. Jejunojejunal Intussusception as the Initial Presentation of Non-Hodgkin’s B-Cell Lymphoma in an Adult Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    V. Stohlner

    2013-01-01

    Full Text Available Introduction. Intussusception is a rare cause of bowel obstruction in adults and is usually associated with an underlying pathology, benign, or malignant. This is a report of a case of jejunojejunal intussusception secondary to non-Hodgkin’s B-cell lymphoma in an adult patient. Case Presentation. A 74-year-old male with no previous significant medical history presented with symptoms of acute intestinal obstruction. A CT scan of the abdomen and pelvis revealed 2 areas of jejunojejunal intussusception, which were surgically managed successfully. Histopathological examination of the specimen revealed the presence of high grade diffuse large B-cell-type non-Hodgkin’s lymphoma, and the patient was referred to the oncology team for further management. Discussion. B-cell lymphoma is a rare but well-documented cause of intussusception in adults, with most cases being at the ileocolic region. We present a rare case of jejunojejunal intussusception as the initial presentation of non-Hodgkin’s B-cell lymphoma in an adult patient.

  10. Comparison of the endogenous ileal and faecal amino acid excretion in the dog (Canis familiaris) and the rat (Rattus rattus) determined under protein-free feeding and peptide alimentation.

    Science.gov (United States)

    Hendriks, W H; Sritharan, K; Hodgkinson, S M

    2002-10-01

    The aim of the study was to determine and compare the endogenous ileal excretions of nitrogen and amino acids under protein-free and peptide alimentation by the dog and rat. Two diets were prepared, one that was devoid of protein and the other containing 23% enzyme hydrolysed casein. Chromic oxide was included in the diets as an indigestible marker. A total of 10 mixed breed dogs were fed hourly either a protein-free or enzymatically hydrolysed casein diet for a total of 10 days. A faecal sample was obtained from each dog on day 9 while digesta was obtained from the terminal 20 cm of the ileum directly after euthanasia on day 10. A total of 12 8-week-old Sprague-Dawley rats received the same diets as the dogs. A faecal sample from each rat was obtained on day 7 while ileal digesta samples were obtained on day 8. The endogenous ileal excretions of most amino acids were greater in the dogs and rats that received the enzymatically hydrolysed casein diet compared with those receiving the protein free diet. Whereas the pattern of endogenous amino acid excretion was similar in the rats and dogs, the dogs excreted a significantly greater amount of nitrogen (1.91 vs. 2.27 and 1.63 vs. 4.12 g/kg dry matter intake for the protein-free and peptide alimentation method, respectively) and all amino acids except for glycine, isoleucine and leucine. Endogenous ileal amino acid excretions are higher in dogs compared to omnivorous animals such as rats and pigs but similar to the carnivorous cat.

  11. ILEAL DIGESTIBILITY OF AMINO ACIDS IN WHEAT GERM - A BY-PRODUCT OF THE MILL INDUILEAL DIGESTIBILITY OF AMINO ACIDS IN WHEAT GERM - A BY-PRODUCT OF THE MILL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Matej Brestenský

    2013-02-01

    Full Text Available The 6 cannulated gilts, with initial body weight (BW 34.8 ± 0.7 kg, fitted with ileal T-cannula in terminal ileum were used for estimation apparent (AID and standardized (SID ileal digestibility of nitrogen (N and amino acids (AA in wheat germs. Animals were fed twice a day with tested diet in two equal doses at daily rate of 75 - 80 g.kg - 0.75. Water was offered ad libitum. The test feed was the only source of protein in the diet. After the 14 d postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed postoperative period followed 6 d adaptation period during which animals fed an experimental diet, on d 7 we collected ileal digesta continuously for 24 h. Chromium oxide (Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculat(Cr2O3 was used as an indigestible marker in amount of 0.3 % per kg of diet. We calculated AID and SID of AA and N using analytic estimated values of N, Cr2O3, and AA. The SID of AA in wheat germs ranged from 86.6 % (tyrosine to 97.6 % (proline (P < 0.05. Ileal digestibility for lysine

  12. Ileal adhesion of virulent E. coli LF82 is not enhanced in Crohn’s disease

    DEFF Research Database (Denmark)

    Jensen, Rikke S.; Fink, Lisbeth Nielsen; Pedersen, Susanne Brix

    2011-01-01

    Adherent-invasive Escherichia coli (AIEC) comprise a new group of E. coli species named from their distinctive ability to adhere to and invade the intestinal epithelium. The AIEC strains have been associated to the ileal mucosa in Crohn’s disease (CD), and the impact of AIEC in the pathogenesis...... of CD has been further strengthened from the evidence that the ileum in CD harbors an abnormally high number of E. coli species. S16 2010 IBD Abstracts The aim of this study was to examine the adhesion of the AIEC reference strain, LF82, to tissue samples from ileum and colon in CD and healthy controls....... A second purpose was to assess the probiotic efficacy of E. coli Nissle 1917 (ECN) in averting LF82 adhesion to ileal mucosa. Ileal and colonic specimens were obtained from patients with CD ileitis and controls (n¼10). A model was developed to investigate bacterial adhesion to intestinal biopsies...

  13. Stone risk after bladder substitution with the ileal-urethral Kock reservoir

    DEFF Research Database (Denmark)

    Osther, P J; Poulsen, A L; Steven, K

    2000-01-01

    OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS: The partic......OBJECTIVE: The study was carried out to compare urinary biochemical and physicochemical environments in patients who had undergone bladder substitution with the ileal-urethral Kock reservoir, and who had no actual urinary infection, with those of healthy subjects. MATERIAL AND METHODS......: The participants were 23 male patients who had undergone bladder substitution with the ileal-urethral Kock reservoir and 25 healthy men. All subjects had sterile urine at the time of urine collection. Concentrations of calcium, magnesium, phosphorus, creatinine, citrate, oxalate, and ammonia in 24-h urine samples...

  14. Image analysis in multisample biopsy after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Giarnieri, E; Giovagnoli, M R; Montesani, C; Nagar, C; Pronio, A M; Alderisio, M; Ribotta, G; Vecchione, A

    1996-01-01

    Pouchitis in ileal anal anastomosis represents an important clinical complication after restorative proctocolectomy. Acute and chronic inflammation of the reservoir is a frequent event sometimes associated with villous atrophy and colonic metaplasia. After ileal pouch anastomosis, twenty-one patients affected by ulcerative colitis were studied. An image analyzer CAS 200 (Becton Dickinson) was utilized to evaluate the DNA intranuclear content in every biopsy. In two cases abnormal DNA distribution was observed, and in one case a poliploid pattern was seen. Abnormal DNA distribution was also present in colonic metaplasia. Therefore, image analysis for the detection of DNA aneuploidy may be of additional value together with histologic parameters in follow up, in order to exclude transformation of the ileal mucosa in neoplastic epithelia.

  15. Isolated ileal perforation in infancy: a lethal initial presentation of Hirschsprung’s disease

    Directory of Open Access Journals (Sweden)

    Fadi Iskandarani

    2017-06-01

    Full Text Available A rare case of ileal perforation, as a fatal initial presentation of total colonic aganglionosis (TCA in infancy is reported. A 10-week-old boy, was brought to the emergency department with symptoms of complicated intestinal obstruction. He looked ill, was lethargic, markedly dehydrated and had a severely distended abdomen. An abdominal X-ray revealed multiple air fluid levels seen in a distended small intestine. During exploratory laparotomy the ileum was massively dilated with distal segment perforation. Ileal perforation repair was performed. A totally collapsed microcolon was identified. Biopsies were taken from the high rectum, sigmoid and hepatic flexure. Appendectomy and ileostomy were performed. All biopsies, as well as the appendix, showed absence of ganglion cells. Despite this procedure the patient progressively deteriorated and later died due to sepsis. Ileal perforation in infants is a rare, but potentially fatal initial presentation of TCA. Early detection is essential to prevent life-threatening complications.

  16. Ileal Neobladder: An Important Cause of Non-Anion Gap Metabolic Acidosis.

    Science.gov (United States)

    St Clair, Jesse W; Wong, Matthew L

    2017-05-01

    The differential diagnosis for a non-anion gap metabolic acidosis is probably less well known than the differential diagnosis for an anion gap metabolic acidosis. One etiology of a non-anion gap acidosis is the consequence of ileal neobladder urinary diversion for the treatment of bladder cancer. We present a case of a patient with an ileal neobladder with a severe non-anion gap metabolic acidosis caused by a urinary tract infection and ureteroenterostomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Part of the ileal neobladder surgery includes ureteroenterostomy and predisposes patients to several clinically significant metabolic derangements, including a non-anion gap metabolic acidosis. These patients have an increased chronic acid load, bicarbonate deficit, and hypokalemia, which should be appreciated when resuscitating these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Terminal Ballistics

    CERN Document Server

    Rosenberg, Zvi

    2012-01-01

    This book covers the important issues of terminal ballistics in a comprehensive way combining experimental data, numerical simulations and analytical modeling. The first chapter reviews the experimental equipment which are used for ballistic tests and the diagnostics for material characterization under impulsive loading conditions. The second chapter covers essential features of the codes which are used for terminal ballistics such as the Euler vs. Lagrange schemes and meshing techniques, as well as the most popular material models. The third chapter, devoted to the penetration mechanics of rigid penetrators, brings the update of modeling in this field. The fourth chapter deals with plate perforation and the fifth chapter deals with the penetration mechanics of shaped charge jets and eroding long rods. The last two chapters discuss several techniques for the disruption and defeating of the main threats in armor design. Throughout the book the authors demonstrate the advantages of numerical simulations in unde...

  18. Direct measurement of first-pass ileal clearance of a bile acid in humans

    International Nuclear Information System (INIS)

    Galatola, G.; Jazrawi, R.P.; Bridges, C.; Joseph, A.E.; Northfield, T.C.

    1991-01-01

    The purpose of this study was to develop and validate a method of directly measuring ileal bile acid absorption efficiency during a single enterohepatic cycle (first-pass ileal clearance). This has become feasible for the first time because of the availability of the synthetic gamma-labeled bile acid 75Selena-homocholic acid-taurine (75SeHCAT). Together with the corresponding natural bile acid cholic acid-taurine (labeled with 14C), SeHCAT was infused distal to an occluding balloon situated beyond the ampulla of Vater in six healthy subjects. Completion of a single enterohepatic cycle was assessed by obtaining a plateau for 75SeHCAT activity proximal to the occluding balloon, which prevented further cycles. Unabsorbed 75SeHCAT was collected after total gut washout, which was administered distal to the occluding balloon. 75SeHCAT activity in the rectal effluent measured by gamma counter was compared with that of absorbed 75SeHCAT level measured by gamma camera and was used to calculate first-pass ileal clearance. This was very efficient (mean value, 96%) and showed very little variation in the six subjects studied (range, 95%-97%). A parallel time-activity course in hepatic bile for 14C and 75Se during a single enterohepatic cycle, together with a ratio of unity for 14C/75Se in samples obtained at different time intervals, suggests that 75SeHCAT is handled by the ileum like the natural bile acid cholic acid-taurine. Extrapolation of 75SeHCAT first-pass ileal clearance to that of the natural bile acid therefore seems justifiable. In a subsidiary experiment, ileal absorption efficiency per day for 75SeHCAT was also measured by scanning the gallbladder area on 5 successive days after the measurement of first-pass ileal clearance. In contrast with absorption efficiency per cycle, absorption efficiency per day varied widely (49%-86%)

  19. Application of Yang-Monti Principle in Ileal Ureter Substitution: Is It a beneficial Modification?

    Directory of Open Access Journals (Sweden)

    M. Esmat

    2012-12-01

    Full Text Available Purpose Ureteric substitution using the Yang-Monti principle was reported as a modification of simple ileal ureter replacement. In this study, we evaluate its safety, surgical outcome and impact on renal function. Materials and Methods Sixteen patients underwent ileal ureter replacement using the Yang-Monti principle to overcome long ureteric defects. Exclusion criteria included patients with elevated serum creatinine > 1.8 mg/dL, inflammatory bowel syndrome or irradiated bowel. Antireflux implantation into the bladder was performed in 12 patients while 4 patients with intact healthy lower ureters underwent distal ileal-ureteral anastomosis. Follow-up protocol was carried out for up to 3 years in 9 patients. Results No intra-operative or postoperative mortality or significant complications occurred. There were minor complications in the form of urinary leakage that necessitated prolonged ureteric stenting in one patient, superficial wound infection in another one and 3 patients developed treatable urinary tract infection without late harmful effects. During follow up, no excess mucus production or metabolic abnormalities were encountered. All patients had preserved renal function (improved in 13 patients and stabilized in 3 without any evidence of urinary obstruction. Conclusions The reconfigured ileal segment for ureteric substitution is a safe technique with an excellent outcome. It uses short ileal segments for reconstruction of an ileal tube of adequate length and optimal caliber that permits easy antireflux implantation into the bladder so it is not associated with excess mucus production or metabolic abnormalities and offers a durable preservation of renal function without urinary obstruction.

  20. GATA4 Is Sufficient to Establish Jejunal Versus Ileal Identity in the Small IntestineSummary

    Directory of Open Access Journals (Sweden)

    Cayla A. Thompson

    2017-05-01

    Full Text Available Background & Aims: Patterning of the small intestinal epithelium along its cephalocaudal axis establishes three functionally distinct regions: duodenum, jejunum, and ileum. Efficient nutrient assimilation and growth depend on the proper spatial patterning of specialized digestive and absorptive functions performed by duodenal, jejunal, and ileal enterocytes. When enterocyte function is disrupted by disease or injury, intestinal failure can occur. One approach to alleviate intestinal failure would be to restore lost enterocyte functions. The molecular mechanisms determining regionally defined enterocyte functions, however, are poorly delineated. We previously showed that GATA binding protein 4 (GATA4 is essential to define jejunal enterocytes. The goal of this study was to test the hypothesis that GATA4 is sufficient to confer jejunal identity within the intestinal epithelium. Methods: To test this hypothesis, we generated a novel Gata4 conditional knock-in mouse line and expressed GATA4 in the ileum, where it is absent. Results: We found that GATA4-expressing ileum lost ileal identity. The global gene expression profile of GATA4-expressing ileal epithelium aligned more closely with jejunum and duodenum rather than ileum. Focusing on jejunal vs ileal identity, we defined sets of jejunal and ileal genes likely to be regulated directly by GATA4 to suppress ileal identity and promote jejunal identity. Furthermore, our study implicates GATA4 as a transcriptional repressor of fibroblast growth factor 15 (Fgf15, which encodes an enterokine that has been implicated in an increasing number of human diseases. Conclusions: Overall, this study refines our understanding of an important GATA4-dependent molecular mechanism to pattern the intestinal epithelium along its cephalocaudal axis by elaborating on GATA4’s function as a crucial dominant molecular determinant of jejunal enterocyte identity. Microarray data from this study have been deposited into

  1. Termination unit

    Energy Technology Data Exchange (ETDEWEB)

    Traeholt, Chresten; Willen, Dag; Roden, Mark; Tolbert, Jerry C.; Lindsay, David; Fisher, Paul W.; Nielsen, Carsten Thidemann

    2016-05-03

    Cable end section comprises end-parts of N electrical phases/neutral, and a thermally-insulation envelope comprising cooling fluid. The end-parts each comprises a conductor and are arranged with phase 1 innermost, N outermost surrounded by the neutral, electrical insulation being between phases and N and neutral. The end-parts comprise contacting surfaces located sequentially along the longitudinal extension of the end-section. A termination unit has an insulating envelope connected to a cryostat, special parts at both ends comprising an adapter piece at the cable interface and a closing end-piece terminating the envelope in the end-section. The special parts houses an inlet and/or outlet for cooling fluid. The space between an inner wall of the envelope and a central opening of the cable is filled with cooling fluid. The special part at the end connecting to the cryostat houses an inlet or outlet, splitting cooling flow into cable annular flow and termination annular flow.

  2. PREDICTING THE COURSE AND OUTCOME OF THE TREATMENT OF INTUSSUSCEPTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. V. Veselyi

    2015-09-01

    Full Text Available The catamnesis in 150 children with an intussusception in terms from 6 months till 10 years after surgical intervention is investigated. Complex biochemical and immunological inspection is carried out to 30 patients. Besides morphological research 10 bioptats of the taken parietal peritoneum, is carried out during operative treatment. Studying before-, intra-and postoperative condition of patients, and also forecasting of current and outcome of disease carried out as a result of search of the «risk factors» determining probability of occurrence and gravity of clinical current of the invagination of intestine in children. In the early postoperative period 4 children (2.7 % have died in connection with an incompetence of the anastomosis, plural intestinal fistulas and progressing of the peritonitis. Catamnesis observation has revealed, that 104 (69.3 % the child after operative desinvagination grew and developed according to age. 34 patients (22.7 % further had the gastroenteropathy described periodic dysphagia and dyspepsia by the phenomena. In 12 children (8.0 % the adhesive disease has developed. Patients with high risk of occurrence of late complications after operative desinvagination require long-term observation and rehabilitation actions.

  3. Jejuno-ileal diverticulitis with localized perforation: CT and US findings

    Energy Technology Data Exchange (ETDEWEB)

    Grana, Lucia [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: lu_rx@hotmail.com; Pedraja, Inigo [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: ipedraja@yahoo.es; Mendez, Ramiro [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: rmendez.hcsc@salud.madrid.org; Rodriguez, Ricardo [Department of Diagnostic Imaging, Hospital Clinico San Carlos, Profesor Martin Lagos, 28040 Madrid (Spain)], E-mail: rrodriguez.hcsc@salud.madrid.org

    2009-08-15

    Purpose: To describe the computed tomography and ultrasound findings of five cases of small bowel diverticulitis with localized perforation. Material and methods: Our database, from April 2003 to August 2007, was reviewed and five cases of small bowel diverticulitis were identified. Results: Jejuno-ileal diverticulitis with covered perforation usually presents as wall thickening of a small bowel loop and an adjacent inflammatory mass containing air bubbles. Conclusion: Small bowel diverticula are rare and mostly asymptomatic. They become clinically relevant when complications arise, such as diverticulitis. The symptoms of jejuno-ileal diverticulitis are non-specific and the diagnosis is performed mainly by imaging studies.

  4. Jejuno-ileal diverticulitis with localized perforation: CT and US findings

    International Nuclear Information System (INIS)

    Grana, Lucia; Pedraja, Inigo; Mendez, Ramiro; Rodriguez, Ricardo

    2009-01-01

    Purpose: To describe the computed tomography and ultrasound findings of five cases of small bowel diverticulitis with localized perforation. Material and methods: Our database, from April 2003 to August 2007, was reviewed and five cases of small bowel diverticulitis were identified. Results: Jejuno-ileal diverticulitis with covered perforation usually presents as wall thickening of a small bowel loop and an adjacent inflammatory mass containing air bubbles. Conclusion: Small bowel diverticula are rare and mostly asymptomatic. They become clinically relevant when complications arise, such as diverticulitis. The symptoms of jejuno-ileal diverticulitis are non-specific and the diagnosis is performed mainly by imaging studies.

  5. Clinical Significance of Lymph Node Metastasis in the Mesentery of the Terminal Ileum in Patients With Right-sided Colon Tumors at Different Locations.

    Science.gov (United States)

    Kang, Sung Il; Kim, Duck-Woo; Shin, Eun; Kim, Myung Jo; Son, Il Tae; Oh, Heung-Kwon; Kang, Sung-Bum

    2018-06-01

    There are limited reports on peri-ileal lymph node metastasis in patients with right-sided colon cancer, and little is known about their clinical significance. This study aimed to examine the role of tumor location in the prevalence and clinical significance of peri-ileal lymph node metastasis in patients with right-sided colon cancer. This is a retrospective study from a prospective cohort database. The study was conducted at a tertiary referral hospital. Patients with right-sided colon cancer treated with radical surgery in a hospital between May 2006 and September 2016 were included. The frequency of peri-ileal lymph node metastasis in the study cohort and the role of tumor location and the clinical characteristics of patients with peri-ileal lymph node metastasis were determined. We examined 752 cases with right-sided colon cancer including 82 cecal, 554 ascending colon, and 116 hepatic flexure cancer. Twenty patients (2.7%) had peri-ileal lymph node metastasis. The incidence of metastasis to peri-ileal lymph nodes was 7.3% (6/82) in patients with cecal cancer, 2.2% (12/554) in patients with ascending colon cancer, and 1.7% (2/116) in patients with hepatic flexure cancer. Three patients had stage III cancer and 17 had stage IV. All 3 patients with positive peri-ileal lymph nodes and stage III cancer had cecal tumors. In contrast, all patients with ascending colon or hepatic flexure cancer and positive peri-ileal lymph nodes had stage IV cancer. The results were limited by the retrospective design of the study and the small number of patients with peri-ileal lymph node metastasis. Peri-ileal lymph node metastasis was rare even in right-sided colon cancer and occurred mainly in stage IV. However, it occurred in some patients with locally advanced cecal cancer. These results suggest that optimal resection of the mesentery of the terminal ileum might have clinical benefit, especially in curative surgery for cecal cancer. See Video Abstract at http

  6. Henoch-Schönlein purpura complicated by acalculous cholecystitis and intussusception, and following recurrence with appendicitis.

    Science.gov (United States)

    Özkaya, Ahmet Kağan; Güler, Ekrem; Çetinkaya, Ahmet; Karakaya, Ali Erdal; Göksügür, Yalçın; Katı, Ömer; Güler, Ahmet Gökhan; Davutoğlu, Mehmet

    2016-05-01

    Henoch-Schönlein purpura (HSP) is the most common childhood systemic vasculitis. Gastro-intestinal involvement occurs in two-thirds of patients. The characteristic skin lesions generally precede abdominal symptoms or present concurrently. A 7-year-old boy presented with intussusception and acalculous cholecystitis and had a cholecystectomy. Two weeks later he was re-admitted with features typical of HSP which responded to corticosteroids. Eleven months later he presented with abdominal pain and recurrence of HSP and, at laparotomy, there was acute appendicitis. This is the first case of a child presenting with HSP complicated by acalculous cholecystitis.

  7. Hand-assisted laparoscopic versus open restorative proctocolectomy with ileal pouch anal anastomosis - a randomized trial

    NARCIS (Netherlands)

    Maartense, Stefan; Dunker, Michalda S.; Slors, J. Frederick; Cuesta, Miguel A.; Gouma, Dirk J.; van Deventer, Sander J.; van Bodegraven, Ad A.; Bemelman, Willem A.

    2004-01-01

    Objective: The aim of the study was to evaluate postoperative recovery after hand-assisted laparoscopic or open restorative proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis in a randomized controlled trial. Methods: Sixty patients were

  8. Screening of Viral Pathogens from Pediatric Ileal Tissue Samples after Vaccination

    Directory of Open Access Journals (Sweden)

    Laura Hewitson

    2014-01-01

    Full Text Available In 2010, researchers reported that the two US-licensed rotavirus vaccines contained DNA or DNA fragments from porcine circovirus (PCV. Although PCV, a common virus among pigs, is not thought to cause illness in humans, these findings raised several safety concerns. In this study, we sought to determine whether viruses, including PCV, could be detected in ileal tissue samples of children vaccinated with one of the two rotavirus vaccines. A broad spectrum, novel DNA detection technology, the Lawrence Livermore Microbial Detection Array (LLMDA, was utilized, and confirmation of viral pathogens using the polymerase chain reaction (PCR was conducted. The LLMDA technology was recently used to identify PCV from one rotavirus vaccine. Ileal tissue samples were analyzed from 21 subjects, aged 15–62 months. PCV was not detected in any ileal tissue samples by the LLMDA or PCR. LLMDA identified a human rotavirus A from one of the vaccinated subjects, which is likely due to a recent infection from a wild type rotavirus. LLMDA also identified human parechovirus, a common gastroenteritis viral infection, from two subjects. Additionally, LLMDA detected common gastrointestinal bacterial organisms from the Enterobacteriaceae, Bacteroidaceae, and Streptococcaceae families from several subjects. This study provides a survey of viral and bacterial pathogens from pediatric ileal samples, and may shed light on future studies to identify pathogen associations with pediatric vaccinations.

  9. Kinetics of primary bile acids in patients after proctocolectomy and ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Gotthardt, Daniel Nils; Sauer, Peter; Schaible, Anja; Stern, Josef; Stiehl, Adolf; Beuers, Ulrich

    2014-01-01

    The high incidence of cholesterol gallstones in patients after proctocolectomy with ileal pouch-anal anastomosis (IPAA) may be due to an increased loss of bile acids. We aimed to evaluate the kinetics of the primary bile acids cholic acid (CA) and chenodeoxycholic acid (CDCA) in these patients. Pool

  10. [Organisation and early outcome of restorative proctocolectomy and ileal pouch-anal anastomosis

    DEFF Research Database (Denmark)

    Ljungmann, K.; Bendixen, A.; Laurberg, S.

    2008-01-01

    INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has become the operation of choice for patients with ulcerative colitis and familial polyposis. However, the procedure is complex with a long learning curve, and carries a risk of both early and late complications...

  11. Sources and severity of self-reported food intolerance after ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Steenhagen, E.; Roos, de N.M.; Bouwman, C.A.; Laarhoven, van C.J.H.M.; Staveren, van W.A.

    2006-01-01

    Data on food intolerance after ileal pouch-anal anastomosis are scarce. The aim of this study was to identify foods causing intolerance and to determine the nature and severity of reported symptoms. Patients from the Dutch Crohn's and Ulcerative Colitis Association were mailed a survey on food

  12. True ileal amino acid digestibility of goat and cow milk infant formulas

    NARCIS (Netherlands)

    Rutherfurd, S.M.; Darragh, A.J.; Hendriks, W.H.; Prosser, C.G.; Lowry, D.

    2006-01-01

    Goat milk is used as an alternative to cow milk for the production of infant formulas. However, little is known about the protein quality and, specifically, about the digestible AA pattern of goat milk formulas compared with their cow milk counterparts. In this study, the true ileal AA digestibility

  13. [Use of surgical staplers in proctocolectomy with ileal pouch. Effects on immediate results].

    Science.gov (United States)

    Montesani, C; Pronio, A; De Milito, R; Narilli, P; D'Amato, A; Ribotta, G

    1992-04-01

    The immediate results of 37 restorative proctocolectomies are reported comparing morbidity of stapled vs manual procedures. The stapled technique is easier and faster but does not reduce the incidence of leakages and pelvic sepsis related to the ileal pouch. It seems, though, to be more useful in reducing the morbidity related to the ileoanal anastomosis.

  14. Terminal ballistics

    CERN Document Server

    Rosenberg, Zvi

    2016-01-01

    This book comprehensively discusses essential aspects of terminal ballistics, combining experimental data, numerical simulations and analytical modeling. Employing a unique approach to numerical simulations as a measure of sensitivity for the major physical parameters, the new edition also includes the following features: new figures to better illustrate the problems discussed; improved explanations for the equation of state of a solid and for the cavity expansion process; new data concerning the Kolsky bar test; and a discussion of analytical modeling for the hole diameter in a thin metallic plate impacted by a shaped charge jet. The section on thick concrete targets penetrated by rigid projectiles has now been expanded to include the latest findings, and two new sections have been added: one on a novel approach to the perforation of thin concrete slabs, and one on testing the failure of thin metallic plates using a hydrodynamic ram.

  15. Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Nährig Jörg

    2010-06-01

    Full Text Available Abstract Background Colonic intussusception is a rare congenital abnormality, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction with or without bleeding. In adults it may occur idiopathically or due to an intraluminal tumor mass. Case presentation A 25-year-old man presented with an acute abdomen and severe crampy abdominal pain. The clinical picture mimicked acute appendicitis. Transabdominal ultrasound examination revealed a 5 cm circular mass in the right upper abdomen. The ensuing computed tomography suggested an intussusception in the ascending colon. Intraoperatively, no full thickness invagination was detected. Due to a hard, intraluminal tumor a standard right hemicolectomy with ileotransversostomy was performed. The histopathological analysis revealed a cystic colon duplication leading to mucosal invagination and obstruction. Conclusions In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions. Unlike its preferentially nonsurgical management in children, a bowel intussusception in adults should be operated because an organic, often malignant lesion is present in most cases.

  16. Ileal Digestibility of Amino Acids in Selected Feed Ingredients Fed to Young Growing Pigs.

    Science.gov (United States)

    Casas, G A; Jaworski, N W; Htoo, J K; Stein, H H

    2018-03-20

    An experiment was conducted to determine the standardized ileal digestibility (SID) of CP and AA in brewers rice, full-fat rice bran (FFRB), defatted rice bran (DFRB), peanut meal, sesame meal, rapeseed meal, rapeseed expellers, soybean expellers, cassava meal, and bakery meal fed to young growing pigs. Twenty-two barrows (initial BW: 14.09 ± 1.48 kg) were surgically fitted with a T-cannula in the distal ileum and randomly allotted to a replicated 11 × 4 incomplete Latin square design with 11 diets and four 7-d periods in each square. Eleven experimental diets were prepared and test ingredients were the sole source of CP and AA in 10 diets and the eleventh diet was a N-free diet used to measure basal ileal endogenous losses of CP and AA. Chromic oxide (0.4%) was included in all diets as an indigestible marker and ileal digesta were collected on d 6 and 7 of each period. Results indicated that the SID of CP and AA was greatest (P < 0.05) in brewers rice and sesame meal and least (P < 0.05) in cassava meal. The SID of indispensable AA was greater (P < 0.05) in sesame meal compared with all other ingredients except brewers rice. Full-fat rice bran had greater (P < 0.05) SID of Arg, Ile, Leu, Lys, and Met compared with DFRB. The SID of CP and most AA was not different among rapeseed meal, rapeseed expellers, and soybean expellers. Bakery meal had the least (P < 0.05) SID of most AA compared with all other ingredients, with the exception of cassava meal. The concentration of standardized ileal digestible CP was greater (P < 0.05) in sesame meal and peanut meal (482.32 and 452.44 g/kg DM, respectively) than in all other ingredients. Soybean expellers had the greatest (P < 0.05) concentration of standardized ileal digestible Lys (22.98 g/kg DM) followed by rapeseed meal (16.11 g/kg DM) and rapeseed expellers (16.17 g/kg DM). Cassava meal and bakery meal had the least (P < 0.05) concentration of standardized ileal digestible CP and most AA compared with the other

  17. Termination unit

    Science.gov (United States)

    Traeholt, Chresten [Frederiksberg, DK; Willen, Dag [Klagshamn, SE; Roden, Mark [Newnan, GA; Tolbert, Jerry C [Carrollton, GA; Lindsay, David [Carrollton, GA; Fisher, Paul W [Heiskell, TN; Nielsen, Carsten Thidemann [Jaegerspris, DK

    2014-01-07

    This invention relates to a termination unit comprising an end-section of a cable. The end section of the cable defines a central longitudinal axis and comprising end-parts of N electrical phases, an end-part of a neutral conductor and a surrounding thermally insulation envelope adapted to comprising a cooling fluid. The end-parts of the N electrical phases and the end-part of the neutral conductor each comprising at least one electrical conductor and being arranged in the cable concentrically around a core former with a phase 1 located relatively innermost, and phase N relatively outermost in the cable, phase N being surrounded by the neutral conductor, electrical insulation being arrange between neighboring electrical phases and between phase N and the neutral conductor, and wherein the end-parts of the neutral conductor and the electrical phases each comprise a contacting surface electrically connected to at least one branch current lead to provide an electrical connection: The contacting surfaces each having a longitudinal extension, and being located sequentially along the longitudinal extension of the end-section of the cable. The branch current leads being individually insulated from said thermally insulation envelope by individual electrical insulators.

  18. Long-term Outcomes of Augmentation Enterocystoplasty with an Ileal Segment in Patients with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Jing-Liang Chen

    2009-06-01

    Conclusion: AE with an ileal segment provides effective and safe therapeutic outcomes in SCI patients. However, problems with UTI, reservoir calculi and new-onset upper tract urolithiasis still need to be solved.

  19. Ileal transposition surgery produces ileal length-dependent changes in food intake, body weight, gut hormones and glucose metabolism in rats.

    Science.gov (United States)

    Ramzy, A R; Nausheen, S; Chelikani, P K

    2014-03-01

    Enhanced stimulation of the lower gut is hypothesized to play a key role in the weight loss and resolution of diabetes following bariatric surgeries. Ileal transposition (IT) permits study of the effects of direct lower gut stimulation on body weight, glucose homeostasis and other metabolic adaptations without the confounds of gastric restriction or foregut exclusion. However, the underlying mechanisms and the length of the ileum sufficient to produce metabolic benefits following IT surgery remain largely unknown. To determine the effects of transposing varying lengths of the ileum to upper jejunum on food intake, body weight, glucose tolerance and lower gut hormones, and the expression of key markers of glucose and lipid metabolism in skeletal muscle and adipose tissue in rats. Adult male Sprague-Dawley rats (n=9/group) were subjected to IT surgery with translocation of 5, 10 or 20 cm of the ileal segment to proximal jejunum or sham manipulations. Daily food intake and body weight were recorded, and an intraperitoneal glucose tolerance test was performed. Blood samples were assayed for hormones and tissue samples for mRNA (RT-qPCR) and/or protein abundance (immunoblotting) of regulatory metabolic markers. We demonstrate that IT surgery exerts ileal length-dependent effects on multiple parameters including: (1) decreased food intake and weight gain, (2) improved glucose tolerance, (3) increased tissue expression and plasma concentrations of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), and decreased leptin concentrations and (4) upregulation of key markers of glucose metabolism (glucose transporter-4 (GLUT-4), insulin receptor substrate 1 (IRS-1), adenosine monophosphate-activated protein kinase (AMPK), hexokinase (HK) and phosphofructokinase (PFK)) together with a downregulation of lipogenic markers (fatty acid synthase (FAS)) in muscle and adipose tissue. Together, our data demonstrate that the reduction in food intake and weight gain, increase in lower

  20. Bowel perforation from occult ileal involvement after diagnosis in a case of primary mediastinal large B-cell lymphoma.

    Science.gov (United States)

    De Philippis, Chiara; Di Chio, Maria Chiara; Sabattini, Elena; Bolli, Niccolo

    2016-07-14

    Primary mediastinal large B-cell lymphoma (PMBCL) is confined to the mediastinum or contiguous nodal areas in most cases. Extramediastinal and abdominal involvement, especially at diagnosis, is extremely rare. Our case describes the first case of histologically proven ileal involvement of PMBCL at diagnosis that led to ileal perforation. Positron emission tomography CT could increase the sensitivity of staging by detecting unusual sites of disease localisation, and could impact clinical management. 2016 BMJ Publishing Group Ltd.

  1. The effect of ileal interposition surgery on enteroendocrine cell numbers in the UC Davis type 2 diabetes mellitus rat

    DEFF Research Database (Denmark)

    Hansen, Carl Frederik; Vassiliadis, Efstathios; Vrang, Niels

    2014-01-01

    To investigate the short-term effect of ileal interposition (IT) surgery on gut morphology and enteroendocrine cell numbers in the pre-diabetic UC Davis type 2 diabetes mellitus (UCD-T2DM) rat.......To investigate the short-term effect of ileal interposition (IT) surgery on gut morphology and enteroendocrine cell numbers in the pre-diabetic UC Davis type 2 diabetes mellitus (UCD-T2DM) rat....

  2. Poor Outcomes of Complicated Pouch-Related Fistulas after Ileal Pouch-Anal Anastomosis Surgery

    DEFF Research Database (Denmark)

    Kjaer, M D; Kjeldsen, J; Qvist, N

    2016-01-01

    . Overall pouch failure, defined as pouch excision or a diverting stoma, was seen in 34 (71%) patients, while pouch excision was seen in 23 (48%) of the patients. Patients who developed Crohn's disease had a significantly higher risk of pouch excision, as did patients with an early onset of the fistula...... after ileal pouch-anal anastomosis (P = 0.006 and P = 0.007, respectively). In conclusion, the present study demonstrated a high risk of pouch failure in patients with complicated pouch-related fistulas. Furthermore, it showed that Crohn's disease and the development of early onset fistulas......BACKGROUND AND AIMS: Development of a pouch-related fistula tract is an uncommon but highly morbid complication to restorative proctocolectomy with ileal pouch-anal anastomosis. Pouch failure with permanent ileostomy is reported in 21%-30% of patients, yet the factors contributing to pouch excision...

  3. Sacrocolpopexy with Polypropylene Tape as Valuable Surgical Modification during Cystectomy with Orthotopic Ileal Bladder: Functional Results

    Directory of Open Access Journals (Sweden)

    Marcin Życzkowski

    2015-01-01

    Full Text Available Introduction. Urinary diversion is very often associated with urinary retention and urinary incontinence. In this study, a surgical modification during cystectomy with orthotopic ileal neobladder is presented. Material and Methods. Female patients enrolled in the study (n-24 were subjected to sacrocolpopexy during the operation. Apart from oncological control, the follow-up consisted of 1-hour inlay test and questionnaires (UDI-6 and IIQ-7 in the 3rd, 6th, and 12th month after the operation. In the 12th month after the surgery, the urodynamic pressure-flow test was performed. Outcomes were compared with the control group (n-18 in which sacrocolpopexy was not implemented. Results. The study group was characterised by reduced urinary retention and improved continence. Conclusion. Sacrocolpopexy during cystectomy with orthotopic ileal bladder is a valuable surgical method which provides patients with a better quality of life.

  4. Ileal atresia and multiple jejunal perforations in a premature neonate with gestational alloimmune liver disease

    Directory of Open Access Journals (Sweden)

    Ryan M. McAdams, MD

    2017-04-01

    Full Text Available Recovery after surgical repair of an ileal atresia with or without intestinal perforation requires prolonged exposure to parenteral nutrition (PN that may lead to PN-associated liver disease. Early liver failure and cholestasis out of proportion for PN exposure may be a harbinger for gestational alloimmune liver disease (GALD, a potentially life-threatening condition that often requires liver transplant if not treated in a timely manner. This case report presents a premature neonate with ileal atresia and multiple jejunal perforations who developed liver failure and was later determined to have GALD. Recognition of clinical and laboratory findings consistent with GALD is essential to promote early treatment, which can enhance neonatal outcomes and impact future pregnancies.

  5. How I do it: the stapled ileal J pouch at restorative proctocolectomy.

    LENUS (Irish Health Repository)

    Martin, S T

    2011-12-01

    Ileal pouch-anal anastomosis (IPAA) following proctocolectomy is the preferred option for patients with medically refractory ulcerative colitis, indeterminate colitis, and familial adenomatous polyposis. However, it remains a procedure associated with morbidity and mortality. Pelvic sepsis, pouch fistulae, and anastomotic dehiscence predispose to pouch failure. We report our experience with an adaptation for the formation of the stapled ileal J pouch using the GIA™ 100 stapling device (Covidien, Mansfield, Massachusetts, USA). When creating the J pouch, we remove the bevelled plastic protector from the thin fork of the stapling device, allowing the staple line to be completed to the tip of the stapled efferent limb of the pouch, thereby minimizing potential blind ending in the efferent limb and injury to the transverse staple line.

  6. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-01-01

    Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. PMID:24644380

  7. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    OpenAIRE

    Leila Ghahramani; Saeed Yazdani; Saeed Derakhshani; Abbas Rezaianzadeh; Reza Jalli; Bita Geramizadeh; Ali Reza Safarpour; Salar Rahimikazerooni; Seyed Vahid Hosseini

    2014-01-01

    Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve do...

  8. Interposition of ileal j-pouch for rectum reconstruction in dog.

    Science.gov (United States)

    Ghahramani, Leila; Yazdani, Saeed; Derakhshani, Saeed; Rezaianzadeh, Abbas; Jalli, Reza; Geramizadeh, Bita; Safarpour, Ali Reza; Rahimikazerooni, Salar; Hosseini, Seyed Vahid

    2014-03-01

    The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases.

  9. Ileal atresia and multiple jejunal perforations in a premature neonate with gestational alloimmune liver disease

    OpenAIRE

    McAdams, Ryan M.

    2017-01-01

    Recovery after surgical repair of an ileal atresia with or without intestinal perforation requires prolonged exposure to parenteral nutrition (PN) that may lead to PN-associated liver disease. Early liver failure and cholestasis out of proportion for PN exposure may be a harbinger for gestational alloimmune liver disease (GALD), a potentially life-threatening condition that often requires liver transplant if not treated in a timely manner. This case report presents a premature neonate with il...

  10. Preoperative wireless capsule endoscopy does not predict outcome after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Murrell, Zuri; Vasiliauskas, Eric; Melmed, Gil; Lo, Simon; Targan, Stephan; Fleshner, Phillip

    2010-03-01

    The extent of preoperative small-bowel mucosal inflammation may be an important predictor of pouchitis after ileal pouch-anal anastomosis. This study examined the value of preoperative wireless capsule endoscopy in predicting outcome of ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. Patients undergoing complete wireless capsule endoscopy before ileal pouch-anal anastomosis were identified. Findings on wireless capsule endoscopy were classified as positive (erosions, ulcers or erythema) or negative. Outcome was assessed prospectively and included no pouchitis, acute pouchitis, chronic pouchitis, or de novo Crohn disease. Patients with acute pouchitis, chronic pouchitis, or de novo Crohn disease were considered to have pouch inflammation. The 68 study patients (48 ulcerative colitis; 20 indeterminate colitis) had a median age of 38 years and included 34 males. Median follow-up time after ileostomy closure was 12 months (range, 3-63 months). Wireless capsule endoscopy was positive in 15 patients (22%) and negative in 53 patients (78%). Pouch inflammation was observed in 23 patients (34%), and included 8 patients with acute pouchitis, 3 patients with chronic pouchitis, and 12 patients with de novo Crohn disease. The incidence of acute pouchitis, chronic pouchitis, de novo Crohn disease, and pouch inflammation in the wireless capsule endoscopy-positive patient group was 7%, 7%, 20%, and 33% compared with 13%, 4%, 17%, and 34% in the wireless capsule endoscopy-negative patient group (all P = NS). There was no statistical association between the results of preoperative wireless capsule endoscopy and outcome after ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. There seems to be little value of wireless capsule endoscopy in the preoperative evaluation of these patients.

  11. Ileal Digestibility of Amino Acids in Meat Meal and Soybean Meal Fed to Growing Pigs

    Directory of Open Access Journals (Sweden)

    C. Kong

    2014-07-01

    Full Text Available The objective of this experiment was to determine the concentration and digestibility of crude protein (CP and amino acid (AA in meat meal (MM, and to compare these values with the respective values in soybean meal (SBM. Six barrows (initial body weight = 66.9±3.8 kg surgically fitted with a T-cannula at the distal ileum were allotted to a replicated 3×3 balanced Latin square design with 3 diets and 3 periods. Two experimental diets containing test ingredients as the sole source of AA were prepared to estimate the apparent ileal digestibility (AID for CP and AA by the direct method. An N-free diet was also prepared to estimate basal endogenous losses of CP and AA. All experimental diets contained 5% chromic oxide as an indigestible index. Each period consisted of a 5-d adaptation period and a 2-d of ileal digesta collection period. Ileal digesta samples were collected from 0900 to 1700 on d 6 and 7 of each period. The concentrations of CP, Lys, Met, and Trp in MM and SBM were analyzed to be 64.1, 3.5, 1.1 and 0.6, and 45.6, 2.8, 0.8, and 0.3%, respectively. The AID of all AA except Gly in MM was less (p<0.05 than in SBM. The AID of Lys, Met, and Trp in MM was estimated to be 56.0, 71.7, and 47.1%, respectively. The SID of all AA in MM was less (p<0.05 than in SBM. The SID of Lys, Met, and Trp was 65.1, 79.2, and 78.5%, respectively. In conclusion, the CP and AA contents in MM were greater than those in SBM whereas the ileal digestibility of all AA in MM was less than in SBM.

  12. An unusual case of giant ileal diverticulum–A case report

    Directory of Open Access Journals (Sweden)

    Fang Ju Koh

    Full Text Available Small bowel diverticulosis is rare with an incidence of 1–2% in the general population. It is an uncommon cause of gastrointestinal bleeding that ranges from obscure to overt bleeding. Large ileal diverticula are extremely rare and bleeding complications can result in high overall mortality.A young gentleman presented with persistent per-rectal bleeding and drop in hemoglobin level. He was recently diagnosed with acute myeloid leukemia and was undergoing chemotherapy. A computed tomography scan of the abdomen and pelvis revealed a giant ileal diverticulum. In view of on-going bleeding, he underwent double balloon enteroscopy which revealed active bleeding from an ulcer within the giant ileal diverticulum and successful hemostasis was performed with hemostatic clips.Small bowel diverticulosis though uncommon has to be considered during workup for gastrointestinal bleeding. Endoscopic treatment is a modern approach towards small bowel diverticular bleeding that is effective and less invasive. Keywords: Enteroscopy, Gastrointestinal bleeding, Small bowel diverticula, Case report

  13. The prognostic factors in typhoid ileal perforation: a prospective study of 50 patients.

    Science.gov (United States)

    Adesunkanmi, A R; Ajao, O G

    1997-12-01

    To determine the prognostic factors in typhoid ileal perforation, a prospective study was carried out in 50 patients with typhoid ileal perforation confirmed at operation. Attention was paid to pre-operative and post-operative factors. The sex ratio was 4:1 in favour of male, with an age range of 7-42 years and a mean of 19.5 years. The age and sex had no effect on the prognosis. Late presentation, delay in operation, multiple perforations, and drainage of copious quantities of pus and faecal material from the peritoneal cavity adversely affected the incidence of faecal fistula and the mortality rate. The development of faecal fistula significantly affected the mortality rate. Early presentation, single perforation and moderate amounts of pus/faecal matter draining from the peritoneal cavity enhanced the development of wound infection, wound dehiscence and residual intra-abdominal abscess. Fourteen patients (28%) died, 50% of these within the first 5 post-operative days. Seventy-one per cent of the 14 died within 10 days. Thus, surviving for more than 10 post-operative days tends to give a better chance of recovery. In conclusion, this study has attempted to outline those factors with a strong effect on the progression and outcome of typhoid ileal perforation in Nigerian patients.

  14. Effect of dietary protein content on ileal amino acid digestibility, growth performance, and formation of microbial metabolites in ileal and cecal digesta of early-weaned pigs.

    Science.gov (United States)

    Htoo, J K; Araiza, B A; Sauer, W C; Rademacher, M; Zhang, Y; Cervantes, M; Zijlstra, R T

    2007-12-01

    Diarrhea incidence in weaned pigs may be associated with the concentration of intestinal microbial metabolites (ammonia, amines, and VFA) that are influenced by dietary CP content. Three experiments were conducted to determine effects of a low-protein, AA-supplemented diet on ileal AA digestibility, growth performance, diarrhea incidence, and concentration of microbial metabolites in ileal and cecal digesta of pigs weaned at 14 d of age. In Exp. 1, 8 pigs fitted with a simple T-cannula at the distal ileum were assigned in a crossover design to 2 diets containing 24 or 20% CP using wheat, corn, full-fat soybeans, whey powder, fish meal, and blood plasma as the main ingredients. Supplemental AA were added to the diets to meet the AA standards according to the 1998 NRC recommendations. Chromic oxide was used as an indigestible marker. Diets were fed at 2.5 times the ME requirement for maintenance. The reduction of dietary CP decreased (P water. Dietary CP content did not affect growth performance or fecal consistency scores during the 3-wk study, and diarrhea was not observed. The results of these experiments indicate that lowering the dietary CP content combined with supplementation of AA markedly reduced the production of potentially harmful microbial metabolites in cecal digesta of early-weaned pigs without affecting growth performance.

  15. Xylanase Increased the Ileal Digestibility of Non-Starch Polysaccharides and Concentration of Low Molecular Weight Non-Digestible Carbohydrates in Pigs Fed High Levels of wheat DDGS

    DEFF Research Database (Denmark)

    Pedersen, Mads Brøgger; Yu, Shukun; Arent, Susan

    2015-01-01

    The objective was to study the effect of a commercially available xylanase (CAX), an experimental xylanase (EX), and EX in combination with protease (EXP) on the degradation of nondigestible carbohydrates (NDC) and apparent ileal digestibility (AID) of nutrients in wheat distillers dried grains...... with the control diet. Addition of CAX (P fraction in ileal digesta compared with the control diet, and CAX increased the uronic acid-to-xylose ratio of the ileal insoluble NSP fraction (P

  16. Coal terminal developments

    Energy Technology Data Exchange (ETDEWEB)

    Venter, J.

    2008-02-15

    The article reports developments at many coal terminals worldwide. These include Bulgaria's Port of Bourgas Temrinal 2A, Spain's Tarragona Port Services (TPS) terminal, New Zealand's Lyttleton Port of Christchurch (LPC), Kinder Morgan's terminals in the USA (the International Marine terminal, Cora terminal, Grand Rivers terminal and Fairless Hills terminal) and Croatia's Port of Ploce. Developments at coal terminals in France and Belgium are also summarized. Global transportation services offered by Rhenus are described. 12 photos.

  17. Robotic Assisted Radical Cystoprostatectomy and Intracorporeal Ileal Conduit Urinary Diversion for a Kidney Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Peter A. Caputo

    Full Text Available ABSTRACT Introduction and Objectives: Robotic assisted radical cystectomy (RARC is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. Materials and Methods: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008. His hospital course at time of transplant was complicated by low-level BK virus viremia. Interestingly his trans-urethral bladder tumor resection specimen at time of bladder cancer diagnosis stained positive for SV40. His native kidneys were anuric so bilateral laparoscopic nephrectomy was performed in a staged fashion 2 weeks prior to RARC. Our surgical technique utilizes 6 trocars, of note a 12-mm assistant trocar is placed 1 cm superior to the pubic symphysis, and this trocar is solely used to pass a laparoscopic stapler to facilitate the excision of the ileal segment and the stapled enteric anastomosis. Surgical steps include: identification of native ureters bilaterally (removed en bloc with the bladder specimen; identification of the transplanted ureter at the right bladder dome; posterior bladder and prostate dissection along Denonvilliers’ fascia; development of the space of Retzius; ligation and transection of the bladder and prostate vascular bundles; apical prostate dissection and transection of urethra; left pelvic lymphadenectomy; ilium resection for creation of the ileal conduit; stapled enteric anastomosis; ureteroileal anastomosis; maturation of the ileal conduit stoma. Results: The surgery had no intraoperative complications. Operative time was 443 minutes (7.4 hours. Estimated blood loss was 250 cc. Length of hospital stay was 5 days. The patient

  18. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog

    Directory of Open Access Journals (Sweden)

    Leila Ghahramani

    2014-03-01

    Full Text Available Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty. Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty. In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology. Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03. Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases. Please cite this article as: Ghahramani L, Yazdani S, Derakhshani S, Rezaianzadeh A, Jalli R, Geramizadeh B, Safarpour AR, Rahimikazerooni S, Hosseini SV. Interposition of Ileal J-Pouch for Rectum Reconstruction in Dog. Iran J Med Sci. 2014;39(2:117-122.

  19. Restorative proctocolectomy: histological assessment and cytometric DNA analysis of ileal pouch biopsies.

    Science.gov (United States)

    Pronio, A; Montesani, C; Vecchione, A; Giovagnoli, M G; Giarnieri, E; Nardi, F; Nigri, G; Ribotta, G

    1997-01-01

    The pathological changes and the risk of developing cancer in the ileal pouch mucosa of patients who received restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) were studied. The presence or absence of remaining rectal mucosa below the IPAA in both patients with stapled and handsewn IPAA was also examined. Endoscopy of the ileal pouch was performed on 38 patients at 4, 12, 18 and 36 months after restorative proctocolectomy with ileal pouch. Mucosal biopsy specimens were taken from the ileal reservoir in order to assess the histological incidence of inflammation. In 23 patients, biopsies were taken to perform cytometric DNA analysis. Clinical symptoms of pouchitis (over six evacuations in 24 hours, night-time evacuations, leakage of feces, bloody diarrhea, abdominal pain and fever) were recorded and correlated with the histological findings. Biopsies were also sampled below the ileo-anal anastomosis (IPAA) in order to identify residual rectal mucosa. Results of histological assessment showed various degrees of chronic inflammation increasing over time (from 42 to 60%) while the presence of both acute and chronic inflammation of the reservoir was less frequent (from 18 to 30%). Villous atrophy was present in 39-68% of patients and the grade of villous atrophy was correlated to the grade of inflammation. Clinical pouchitis was present in 3 to 8% of cases at the different controls and it was always associated with the highest grade of histological inflammation and severe villous atrophy. No significant alteration of the DNA cellular content was observed. Very low incidence of aneuploidy (0.7-1% Ex.R.) has been reported in three cases. However, we found dysplasia in only one patient who underwent surgical treatment for familial polyposis coli. IPAA evaluation showed no residual rectal mucosa in 40% of cases with stapled IPAA; in the remaining 60%, we found a small amount of rectal mucosa (maximum 1 cm). We did not find rectal mucosa after handsewn IPAA

  20. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital.

    Science.gov (United States)

    Menke, Jan; Kahl, Fritz

    2015-03-01

    In children with ileocolic intussusception sonography is increasingly being used for diagnosis, whereas fluoroscopy is frequently used for guiding non-invasive reduction. This study assessed the success rate of radiation-free sonography-guided hydrostatic reduction in children with ileocolic intussusception, using novel well-defined success rate indices. All children were evaluated who presented from 2005 to 2013 to the local university hospital with ileocolic intussusception. The patients were treated with sonography-guided hydrostatic reduction unless primary surgery was clinically indicated. The according success rate was determined by indices of Bekdash et al. They represent the ratio of persistently successful non-surgical reductions versus four different denominators, depending on including/excluding cases with primary surgery and including/excluding cases requiring bowel resection/intervention. Fifty-six consecutive patients were included (age, 3 months to 7.8 years). About 80% of the patients presented until 24 h and 20% until 48 h after the onset of symptoms. Seven patients underwent primary surgery, with bowel resection required in three cases. Hydrostatic reduction was attempted in 49 patients, being permanently successful in 41 cases (selective reduction rate 41/49 = 83.7%; crude reduction rate 41/56 = 73.2%). The remaining eight patients underwent secondary surgery, with just two patients not requiring surgical bowel resection/intervention (corrected selective reduction rate 41/43 = 95.3%). The composite reduction rate was 87.2% (successful/feasible reductions, 41/47). Radiation-free sonography-guided hydrostatic reduction has a good success rate in children with ileocolic intussusception. It may be particularly valuable in centers that are already experienced with using sonography for the diagnosis.

  1. Segregation of B lymphocytes into stationary apoptotic and migratory proliferating subpopulations in agglomerate cultures with ileal epithelium.

    Science.gov (United States)

    Alitheen, N; McClure, S; McCullagh, P

    2001-09-01

    The B lymphocyte-epithelial cell interactions that define the microenvironment of the ileal Peyer's patch, the primary B lymphocyte organ of the fetal lamb, have been replicated in tissue culture. Mixed suspensions of ileal epithelial cells, lymphocytes and fibroblasts from fetuses of 63-103 days of gestation organized into macroscopically visible agglomerates within 72 h. These agglomerates contained translucent spherical cavities and were enclosed within a marginal cell layer and surrounded by an expanding corona of emigrating cells. The lining of the cavities and the marginal layer consisted of well-differentiated, polarized columnar ileal epithelial cells. One population of B lymphocytes in the initial mixed suspension differentiated into two discrete populations reproducing the characteristics of intact fetal ileal Peyer's patches. B cells apposed to follicle-associated epithelium (FAE) within agglomerates underwent apoptosis. The other population of emigrant B cells proliferated and expressed the BAQ44A differentiation marker. Differentiation of ileal epithelial cells into FAE, typical of Peyer's patches, was markedly accelerated. The mutually inductive influences of intestinal epithelial cells and B lymphocytes in these agglomerates replicate normal mid-gestational fetal development of the mucosal immune system and afford new opportunities for its further investigation.

  2. Small Bowel Obstruction Secondary to Retrograde Intussusception of the Roux Limb: A Complication Following Laparoscopic Roux–en–Y Gastric Bypass.

    Directory of Open Access Journals (Sweden)

    Ayodele Atolagbe

    2016-07-01

    Full Text Available Small bowel obstruction secondary to intussusception following a roux-en-Y gastric bypass (RYGB for morbid obesity is a rare clinical condition. It has become more frequently diagnosed with the increasing utilization of RYGB for the management of morbid obesity world-wide. We present a 34 year old female who presented at the Emergency Room of our facility with complaints of abdominal pain and a history of retro-colic and ante-gastric laparoscopic Roux-en-Y gastric bypass surgery at another Hospital a year prior to presentation. On account of unremitting abdominal pain, a lactate level of 5.4mg/dl and abdominal Computed Tomographic scan which showed evidence of small bowel obstruction with intussusception; an emergency exploratory laparotomy was done which revealed intussusception of the biliopancreatic and common limb into the distal aspect of the roux limb. Surgical intervention entailed resection of both the proximal common limb and distal roux and biliopancreatic limbs and surgical reconstruction of the jejunojejunal anastomosis. She is alive and well two years post surgery without any recurrence.

  3. Ileal atresia and thrombo-embolic liver calcifications diagnosed after treatment with intrauterine laser coagulation therapy for twin-to-twin transfusion syndrome - Report of 2 cases

    NARCIS (Netherlands)

    Schnater, J. Marco; van Zalen-Sprock, Rieteke M.; Schaap, Artie H. P.; Festen, Sebastiaan; Aronson, Daniel C.

    2005-01-01

    Ileal atresia is considered to be an acquired anomaly. It is thought to be caused by a mesenteric vascular accident during fetal life which leads to necrosis of downstream tissues. We present a case in which ileal atresia occurred after intrauterine laser coagulation therapy for a twin-to-twin

  4. A comparative study between open and laparoscopic approach in radical cystectomy with orthotopic ileal neobladder.

    Science.gov (United States)

    Mateo, E; García-Tello, A; Ramón de Fata, F; Romero, I; Núñez-Mora, C; Angulo, J C

    2015-03-01

    Probably, laparoscopic radical cystectomy with ileal neobladder and neovesicourethral anastomosis is one of the most complex procedures in minimally invasive surgery. Prospective study carried out in 72 patients surgically treated for invasive bladder neoplasia between January 2008 and October 2013. Patients were undergone to radical cystectomy with ileal neobladder (open approach in 33 patients and laparoscopic approach in 39). The study assessed comparatively surgical outcomes, continence rate and postoperative complications. Mean age was 63.5±9 years (64.3 open vs. 62.7 laparoscopic, P=.46) mean surgery time 323.6±78.7 minutes (321.3 vs. 326.5, P=.77), average hospital stay 14.8 days±8,1 (16.2 vs. 13.6, P=.2), transfusion rate 40.3% (66.7% vs. 17.9%, P<.0001) and complications rate 47.2% (63.6% vs. 33.3%, P=.01). Major complications were reported in 29.1% of cases (39.4% open vs. 20,5% laparoscopic, P=.07). With a mean follow-up rate of 42.5±19.2 months (range 15-70), 50 (69.4%) patients remain alive and free of disease. Continence was evaluated in these patients: total continence rate was 38% (50% vs. 27%, P=.09) and diurnal continence rate 58% (70.8% vs. 46.1%, P=.07). Self-catheterization rate was 8% (4.2% vs. 11.5%, P=.67). Total incontinence rate was 34% (25% vs. 42.3%, P=.19). According to our experience, transfusion rate, number and severity of complications are lower in laparoscopic cystectomy with ileal neobladder. No statistically significant impact on operative time and on hospital stay was observed. In patients undergone to laparoscopic approach, continence rate is lower but not statistically significant. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer.

    Science.gov (United States)

    Kim, Kwang Hyun; Yoon, Hyun Suk; Yoon, Hana; Chung, Woo Sik; Sim, Bong Suk; Lee, Dong Hyeon

    2016-07-01

    Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.

  6. Accuracy of prenatal ultrasound in detecting jejunal and ileal atresia: systematic review and meta-analysis.

    Science.gov (United States)

    Virgone, C; D'antonio, F; Khalil, A; Jonh, R; Manzoli, L; Giuliani, S

    2015-05-01

    The accuracy of prenatal ultrasound examination in detecting jejunal and ileal atresia has been reported in the literature to be highly variable, at 25-90%. The aim of this systematic review was to evaluate the accuracy of prenatal ultrasound in detecting non-duodenal small bowel atresia (ND-SBA). MEDLINE, EMBASE and The Cochrane Library, including The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and The Cochrane Central Register of Controlled Trials (CENTRAL), were searched electronically. The overall detection rate of jejunal or ileal atresia using ultrasound was reported. The accuracy of using polyhydramnios and dilated loops of bowel as diagnostic signs was also explored. Sixteen studies involving 640 fetuses were included in this review. The detection rate of ND-SBA by prenatal ultrasound was highly variable, with values ranging from 10 to 100%, with an overall prediction of 50.6% (95% CI, 38.0-63.2%). When analyzed separately, the detection rates of jejunal and ileal atresia were 66.3%, (95% CI, 33.9-91.8%) and 25.9% (95% CI, 4.0-58.0%), respectively. Both dilated loops of bowel and polyhydramnios as diagnostic signs for ND-SBA provided a low overall detection rate. The diagnostic performance of prenatal ultrasound in identifying ND-SBA is extremely variable. Large studies are needed in order to identify objective and combined criteria for the diagnosis of these anomalies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  7. Ileal, colonic and total tract nutrient digestibility in dogs (Canis familiaris) compared with total tract digestibility in mink (Neovison vison)

    DEFF Research Database (Denmark)

    Tjernsbekk, Maria Therese; Tauson, Anne-Helene; Ahlstrøm, Øystein

    2014-01-01

    Mink (Neovison vison) was studied as a model for the determination of ileal crude protein (CP) and amino acid (AA) digestibility in dogs (Canis familiaris). Apparent ileal digestibility (AID) and apparent colonic digestibility (ACD) in dogs and apparent total tract digestibility (ATTD) in dogs...... and mink were measured for dry matter (DM), main nutrients and AA. Standardised ileal digestibility (SID) of CP and AA in dogs was calculated. Twelve dogs and 12 mink divided into three groups were fed one out of three diets differing in CP digestibility. In dogs, AID of CP was lower (74.4%) than ATTD (83.......5%) (p dogs. Digestibility of AA followed the same pattern, and, except for Thr and Ser, ATTD in mink was very close to SID in dogs. Also, AID was close to ATTD in mink for several AA. High correlations were...

  8. Ileal digestibility of sunfl ower meal, pea, rapeseed cake, and lupine in pigs

    DEFF Research Database (Denmark)

    Nørgaard, Jan Værum; Fernández, José Adalberto; Jørgensen, Henry

    2012-01-01

    .05) for soybean meal and pea compared to sunfl ower meal, rapeseed cake, and lupine. The SID of Lys and His were lowest (P soybean meal and pea to be a high-digestible protein source relative to sunfl ower......The standardized ileal digestibility (SID) of CP and AA was evaluated in soybean (Glycine max) meal, sunfl ower (Helianthus annuus) meal, rapeseed cake, and fi eld pea (Pisum sativum) using 10 pigs and in lupine (Lupinus angustifolius) using 7 pigs. Pigs were fi tted with either a T...

  9. Protein digestibility evaluations of meat and fish substrates using laboratory, avian, and ileally cannulated dog assays.

    Science.gov (United States)

    Faber, T A; Bechtel, P J; Hernot, D C; Parsons, C M; Swanson, K S; Smiley, S; Fahey, G C

    2010-04-01

    Meat and fish serve as important protein sources in the companion animal diet; however, limited protein digestibility data are available for assessing protein digestibility differences among good-quality protein sources. Beef loin, pork loin, chicken breast, pollock fillet, and salmon fillet were evaluated for composition, protein digestibility, and AA bioavailability using the immobilized digestive enzyme assay, cecectomized rooster assay, and ileally cannulated dog assay. Pollock contained the greatest amount of CP, total essential AA (TEAA), and total nonessential AA (TNEAA; DM basis; 96.9, 38.6, and 50.3%, respectively). Salmon contained the next greatest amounts (92.8, 36.4, and 44.6%), followed by chicken (90.3, 36.1, 43.2%). Beef had the least CP content (82.7%), but had slightly greater TEAA and TNEAA concentrations (33.9, 42.0%) compared with pork (86.2, 33.6, 41.3%). Immobilized digestive enzyme assay values were greatest for pollock fillet (0.71) and least for chicken breast (0.52). Beef loin, pork loin, and salmon fillet were similar (0.63, 0.62, and 0.64, respectively). Standardized TEAA and TNEAA digestibility coefficients, evaluated using the cecectomized rooster assay, were greatest (P protein source. No significant differences (P > 0.05) were found in ileal digestibility of protein. Values ranged from 88.9% for chicken to 90.5% for pork loin and pollock fillet. Ileal TEAA and TNEAA coefficients were not different among test substrates, with values between 91.7 and 92.7%, and 88.8 and 90.4%, respectively. Total tract CP apparent digestibility values ranged from 94.4 to 94.8%, with no differences noted among treatments. Despite marked differences in composition and predicted and standardized digestibility values, when the protein sources were added to diets at a concentration of approximately 30% (25% of total energy intake), no differences in test protein substrates were noted in either ileal or total tract nutrient digestibility.

  10. Traumatic ileal perforation in post-traumatic ventral hernia: adding insult to injury

    International Nuclear Information System (INIS)

    Rab, A.Z.U.; Fakir, S.B.; Peethambaran, M.S.

    2007-01-01

    Rupture of abdominal wall with formation of ventral hernia is a rare complication following blunt abdominal trauma. Small intestinal rupture within such a hernial sac, resulting from a subsequent blunt trauma is rarer still. Ventral hernias often go untreated in developing countries because of their seemingly innocuous nature, ignorance and financial constraints. Blunt trauma in patients with hernia warrants a thorough clinical examination along with evaluation for intestinal injury, since even trivial trauma can cause potentially serious intra-peritoneal visceral injury. A case of fatal traumatic ileal perforation in pre-existing post-traumatic ventral hernia (from blunt trauma sustained 10 years earlier) is being reported. (author)

  11. Synchronous association of rectal adenocarcinoma and three ileal carcinoids: a case report.

    LENUS (Irish Health Repository)

    McHugh, Seamus M

    2012-02-01

    BACKGROUND: Synchronous midgut carcinoids with gastrointestinal adenocarcinoma are a rare but recognised association. CASE PRESENTATION: The patient, a 74 year old woman, underwent anterior resection for a low rectal adenocarcinoma. Intra-operatively 3 serosal deposits of tumour were noted in the distal ileum. Histology revealed these to be ileal carcinoids. CONCLUSION: During resection of a gastrointestinal tumour, a thorough inspection of the abdominal cavity should be undertaken to investigate the possibility of metastatic secondaries or a synchronous tumour as is reported in this case.

  12. Radical Cystectomy with Ileal Conduit Urinary Diversion in a Patient with a Left Ventricular Assist Device

    Directory of Open Access Journals (Sweden)

    Joseph J. Pariser

    2015-01-01

    Full Text Available Left ventricular assist device (LVAD is an option for the surgical management of severe heart failure, and radical cystectomy remains the standard of care for muscle-invasive bladder cancer. Given a complicated population in terms of comorbidities and management for patients with an LVAD, there is little experience with major urologic procedures, which require balancing the benefits of surgery with considerable perioperative risks. We report our experience performing the first radical cystectomy with ileal conduit in a patient with an LVAD and muscle-invasive bladder cancer.

  13. ktup Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  14. ktop Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  15. kfxe Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  16. kmsy Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  17. kroc Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  18. kacv Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  19. Terminated Multifamily Mortgages Database

    Data.gov (United States)

    Department of Housing and Urban Development — Includes all terminated HUD Multifamily insured mortgages. It includes the Holder and Servicer at the time the mortgage was terminated. The data is good as of...

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  10. krsw Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  11. papg Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  12. kblf Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  13. krdu Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  14. kluk Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  15. keed Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  16. kiwd Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  17. kttn Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  18. kagc Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  19. kbmi Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  20. kapn Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  1. kgon Terminal Aerodrome Forecast

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — TAF (terminal aerodrome forecast or terminal area forecast) is a format for reporting weather forecast information, particularly as it relates to aviation. TAFs are...

  2. Evaluasi Kinerja Angkutan Umum Trayek Terminal Oebobo - Terminal Kupang Pp Dan Terminal Kupang - Terminal Noelbaki Pp

    OpenAIRE

    Safe, Yohanes T; Udiana, I Made; Bella, Rosmiyati A

    2015-01-01

    Beberapa ruas jalan pada Trayek Terminal Oebobo-Terminal Kupang PP dan trayek Terminal Kupang-Terminal Noelbaki PP, pada jam-jam puncak angkutan umum yang ada cenderung digunakan melebihi kapasitas maksimumnya. Keadaan sebaliknya terjadi pada jam non-puncak, kendaraan umum setengah kosong dan harus melakukan kompetisi dengan angkutan umum lainnya untuk mendapatkan penumpang. Tujuan dari penelitian adalah mengetahui kinerja pelayanan angkutan umum, kebutuhan angkutan umum dan membuat rekomenda...

  3. Estimation of the optimum standardized ileal digestible total sulfur amino acid to lysine ratio in late finishing gilts fed low protein diets supplemented with crystalline amino acids.

    Science.gov (United States)

    Ma, Wenfeng; Zhu, Jinlong; Zeng, Xiangfang; Liu, Xutong; Thacker, Philip; Qiao, Shiyan

    2016-01-01

    A total of 90 gilts were used to investigate the effects of various standard ileal digestible (SID) total sulfur amino acid (TSAA) to lysine (Lys) ratios on the performance and carcass characteristics of late finishing gilts receiving low crude protein (CP) diets supplemented with crystalline amino acids (CAA). Graded levels of crystalline methionine (Met) (0, 0.3, 0.5, 0.8 or 1.1 g/kg) were added to the basal diet to produce diets providing SID TSAA to Lys ratios of 0.48, 0.53, 0.58, 0.63 or 0.68. At the termination of the experiment, 30 gilts (one pig per pen) with an average body weight (BW) of 120 kg were killed to evaluate carcass traits. Increasing the SID TSAA to Lys ratio increased average daily gain (ADG) (linear and quadratic effect, P gilts. No effects were obtained for carcass traits. The optimum SID TSAA to Lys ratios to maximize ADG as well as to minimize FCR and SUN levels were 0.57, 0.58 and 0.53 using a linear-break point model and 0.64, 0.62 and 0.61 using a quadratic model. © 2015 Japanese Society of Animal Science.

  4. Recurrent Volvulus of an Ileal Pouch Requiring Repeat Pouchopexy: A Lesson Learnt

    Directory of Open Access Journals (Sweden)

    Pär Myrelid

    2014-01-01

    Full Text Available Introduction. Restorative surgery for ulcerative colitis with ileal pouch anal anastomosis (IPAA is frequently accompanied by complications. Volvulus of the ileal pouch is one of the most rarely reported late complications and to our knowledge no report exists on reoperative surgery for this condition. Case Report. A 58-year-old woman who previously had undergone restorative proctocolectomy due to ulcerative colitis with an IPAA presented with volvulus of the pouch. She was operated with a single row pouchopexy to the presacral fascia. Two months later she returned with a recurrent volvulus. At reoperation, the pouch was found to have become completely detached from the fascia. A new pexy was made by firmly anchoring the pouch with two rows of sutures to the presacral fascia as well as with sutures to the lateral pelvic walls. At follow-up after five months she was free of symptoms. Conclusion. This first report ever on reoperative surgery for volvulus of a pelvic pouch indicates that a single row pouchopexy might be insufficient for preventing retwisting. Several rows seem to be needed.

  5. Evidence for carrier-mediated Cl-SO4 exchange in rabbit ileal basolateral membrane vesicles

    International Nuclear Information System (INIS)

    Schron, C.M.; Knickelbein, R.G.; Aronson, P.S.; Dobbins, J.W.

    1987-01-01

    In rabbit ileal basolateral membrane (BLM) vesicles, an outwardly directed Cl gradient ([Cl] in/out = 60/6 mM) stimulated the initial velocity of 35 SO 4 uptake compared with uptake in the absence of Cl. Under Cl gradient conditions, 35 SO 4 was transiently accumulated at a concentration twice that found at equilibrium (overshoot). Chloride gradient-stimulated SO 4 uptake was markedly reduced by inhibitors of anion exchange and was saturable. SO 4 uptake by BLM vesicles was not stimulated by imposition of an inside-positive electrical potential, suggesting that the stimulation by a Cl gradient was not due to an induced electrical potential. Oxalate, nitrate, iodide, and bromide inhibited the initial velocity of Cl gradient-stimulated SO 4 uptake, whereas phosphate, β-hydroxybutyrate, lactate, and p-aminohippurate had not effect. When 35 SO 4 uptake by BLM vesicles was compared with that of brush-border membrane vesicles, Cl gradient-stimulated SO 4 uptake was found predominantly in the BLM preparation. In conclusion, these findings provide evidence for a carrier on the ileal basolateral membrane that mediates Cl-SO 4 exchange

  6. Extrusion enhances metabolizable energy and ileal amino acids digestibility of canola meal for broiler chickens

    Directory of Open Access Journals (Sweden)

    Aljuobori Ahmed

    2014-01-01

    Full Text Available The aim of the current study was to determine the effect of extrusion process on apparent metabolizable energy (AME, crude protein (CP and amino acid (AA digestibility of canola meal (CM in broiler chickens. A total of 36, 42-day-old broilers were randomly assigned into adaptation diets (no CM or 30% CM with six replicates. After 4 days of adaptation period, on day 47, birds were allowed to consume the assay diets that contain CM or extruded canola meal (ECM as the sole source of energy and protein. Following 4 h after feeding, the birds were killed and ileal contents were collected. The results showed that ECM had greater (P<0.001 AME (10.87 vs 9.39 MJ/kg compared to CM. The extrusion also significantly enhanced apparent ileal digestibility of CP and some of AA such as Asp, Glu, Ser, Thr and Trp. In conclusion, the extrusion treatment appeared to be a practical and effective approach in enhancing the digestibility of AME, CP and some AA of CM in broiler chickens.

  7. Apparent and standardized ileal digestibility of amino acids in diverse barley cultivars fed to growing pigs.

    Science.gov (United States)

    Wang, Hongliang; Ma, Xiaokang; Xu, Xiao; Shi, Meng; Piao, Xiangshu

    2017-12-01

    The objectives of this study were to determine the chemical composition, ileal amino acid (AA) digestibility of barley varieties and to develop equations to predict the AA digestibility based on the chemical characteristics of individual barley. A wide selection of nine barley varieties in the main growing regions of China was used in the experiment. Ten crossbred pigs (30.9 ± 1.8 kg) were allotted to a 6 × 10 Youden Square. The treatments included a nitrogen-free diet and nine barley test diets. Considerable variation was observed in the content of neutral detergent fiber, acid detergent fiber, crude protein (CP) and all AAs among the barley samples. The standardized ileal digestibility (SID) of indispensable AAs with the exception of arginine, phenylalanine and threonine were different (P digestibility of CP and AAs among barley varieties. It is difficult to predict the SID of most of the amino acids in barely based upon chemical characteristics. © 2017 Japanese Society of Animal Science.

  8. Effect of dietary acidification in broiler chickens: 1. Growth performance and nutrients ileal digestibility

    Directory of Open Access Journals (Sweden)

    Fateme Khooshechin

    2015-08-01

    Full Text Available An experiment was conducted to evaluate the effect of dietary Orgacids® (organic acid; OA supplementation on the productive performance, nutrients ileal digestibility, relative weight of organs and serum enzyme activities in broiler chickens. One hundred-sixty Ross 308 male chicks were randomly allotted to 4 dietary treatments: a nutritionally balanced basal diet supplemented with 0, 1, 2 and 3 OA g kg–1 of feed from 7 to 42 d of age. Each treatment had 4 replications with 10 broilers/replicate pen. As a result of this study, body weight, average daily gain and average daily feed intake increased (linear effect, P<0.05 at 3 g kg–1 of OA inclusion, whereas feed conversion ratio was negatively affected by dietary treatments (quadratic, P<0.05 as inclusion of OA increased to 2 g kg-1 and then decreased with further inclusion. Ileal digestibility of total phosphorus and relative weight of pancreas, heart and spleen increased (linear effect, P<0.05 with increasing inclusion of OA. Metabolizable energy corrected to zero nitrogen retention increased linearly and quadratically on increasing OA addition reaching a maximum at 2 g kg–1 diet. The results indicated that serum enzyme activity of alkaline phosphatase and alanine aminotransferase increased (linear effect, P<0.05 with increasing inclusion levels of OA, but lactate dehydrogenase decreased. In conclusion, these findings demonstrate that the OA supplementation at 3 g kg–1 of the diet resulted in optimal growth performance and nutrients digestibility.

  9. Experimental Evaluation of Ileal Patch in Delayed Primary Repair of Penetrating Colon Injuries: An Animal Study

    Directory of Open Access Journals (Sweden)

    Hamid Reza Abbasi

    2006-10-01

    Full Text Available Primary repair of traumatic colonic perforation is progressively gaining acceptance as the best method of management. However, when delayed, the risk of infection-related complications may increase. Here, we present a new method of repairing colon perforation in the presence of peritonitis. Acute colon injury was simulated in 22 German shepherd dogs. The dogs were randomly divided into two groups of 11 and after 24 hours they were operated on. The perforations were repaired by subserosal suture technique. In the first group (group A, ileal patch was used. In the other group (group B, the colon was closed by debridement and anastomosis. After 6 weeks, the repairs were assessed on the basis of survival, gross and histological assessments. Nine (82% dogs in group A and six (56% in group B survived. Ileal patch utilization significantly decreased the mortality rate (p < 0.05. The cause of death in two group A dogs and five group B dogs was peritonitis and intra-abdominal abscess formation. None of the surviving dogs showed evidence of anastomotic leakage or breakdown. Small bowel patch used in primary repair of colon injury in the presence of peritonitis may decrease the risk of postoperative infection-related complications and the mortality rate.

  10. Clinical utility of retrograde terminal ileum intubation in the evaluation of chronic non-bloody diarrhea.

    Science.gov (United States)

    Makkar, Rohit; Lopez, Rocio; Shen, Bo

    2013-10-01

    The aims of this study were to investigate the frequency and factors involved in the terminal ileum intubation of patients with chronic, non-bloody diarrhea and to compare diagnostic yields of colonoscopy and ileocolonoscopy. The medical records of 945 patients undergoing colonoscopy for chronic, non-bloody diarrhea were reviewed. Findings of microscopic colitis, Clostridium difficile colitis, celiac disease, inflammatory bowel disease or tropical sprue were considered as definitive causes of diarrhea. A total of 689 patients met the diagnosis of chronic, non-bloody diarrhea, in which 370 (53.7%) underwent ileocolonoscopy. Specific histological diagnosis could explain the patient's symptoms in 107 (15.5%) patients. The diagnostic yield were 15.0% in the colonoscopy-only group, 16.9% in the ileocolonoscopy without biopsy group, and 15.5% in the ileocolonoscopy with biopsy group. Of the 19 patients with an abnormal terminal ileal biopsy, six (31.6%) had an otherwise normal colonic appearance which would have been diagnosed as normal if the ileum had not been reached and biopsied. In those with Crohn's disease (n = 7), five had ileocolitis and two had colitis only. A multivariate analysis showed that age of the patients and otherwise normal gross endoscopic results to be the only factors associated with a lower likelihood of ileal intubation by endoscopists. The ileal intubation rate was 53.7% in our patients with chronic, non-bloody diarrhea. Diagnostic yield of ileocolonoscopy with biopsy in US patients with chronic, non-bloody diarrhea appeared to be low, if the colon side was normal on endoscopy. But this may provide supportive evidence in patients diagnosed with ileocolonic Crohn's disease. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

  11. Effect of dietary lignocellulose on ileal and total tract digestibility of fat and fatty acids in broiler chickens.

    Science.gov (United States)

    Bogusławska-Tryk, M; Piotrowska, A; Szymeczko, R; Burlikowska, K

    2016-12-01

    The study was conducted to determine the effect of a lignocellulose supplemented diet on apparent ileal and total tract digestibility of fat and fatty acids (FA) in broiler chickens. A total of 48 21-day-old male Ross 308 chickens were divided into four treatment groups (n = 12) with six replicates per treatment. From 21 to 42 days of age, the broilers were fed experimental diets varied in the amount of lignocellulose: 0%, 0.25%, 0.5% and 1%. Total excreta were gathered during the last 3 days of the feeding trial and digesta was collected from the ileum at 42 days of the bird age. Digestibility was determined by the indicator method. The ether extract content in diet/digesta/excreta was determined by the gravimetric method, and fatty acid methyl esters were analysed by gas chromatography-mass spectrometry. Fat digestibility measured to the end of the small intestine and in the whole gastrointestinal tract in birds was high and exceeded 90% and 87% respectively. Addition of lignocellulose (1%) increased (p fat digestibility but had no significant effect on total tract fat digestion. Absorption of total fatty acids (TFA) as well as myristic (C14:0), palmitoleic (C16:1) and α-linolenic (C18:3n-3) acids, estimated by both methods, was significantly higher in birds fed the diets supplemented with lignocellulose, especially at a dose of 1%. Total tract absorption of some dietary polyunsaturated fatty acids (PUFA) (C20:2, C20:4n-6) was significantly lower from diet supplemented with 0.5% and 0.25% lignocellulose. There was observed a decrease in apparent digestibility of fat and most examined fatty acids, when measured between terminal ileum and total gastrointestinal tract. The results suggest that lignocellulose can affect digestion and FA absorption in broilers but, as the effect of lignocellulose was not studied previously, further investigations are necessary to confirm the results of the present experiment. Journal of Animal Physiology and Animal Nutrition

  12. Effects of hulls of faba beans (Vicia faba L.) with a low or high content of condensed tannins on the apparent ileal and fecal digestibility of nutrients and the excretion of endogenous protein in ileal digesta and feces of pigs

    NARCIS (Netherlands)

    Jansman, A.J.M.; Verstegen, M.W.A.; Huisman, J.; Berg, J.W.O. van den

    1995-01-01

    In three experiments (Exp. 1, 2, and 3) with young pigs (BW 10 to 26 kg), the effects of dietary inclusion of hulls of faba beans (Vicia faba L.) (200 g/kg) with a low (< .1% catechin equivalents; LT) or high tannin content (3.3% catechin equivalents; HT) on the apparent ileal (Exp. 1 and 2) and

  13. Organizational Relationship Termination Competence

    DEFF Research Database (Denmark)

    Ritter, Thomas; Geersbro, Jens

    2011-01-01

    Most firms are involved in a number of customer relationships that drain the firm's resources. However, many firms are hesitant to address this problem. This paper investigates customer relationship termination at the organizational level. We develop and analyze the organizational dimensions...... that a firm's percentage of unwanted customers decreases significantly as acceptance of termination increases, if the firm's definition of unwanted customers is well understood, and if a firm has clear termination routines. In addition, general focus on profitability and external constraints on relationship...... termination are found to significantly affect a firm's relationship termination competence. The findings suggest that managers should regard termination as a legitimate option in customer relationship management. In order to decrease the number of unwanted customers, managers must accept termination...

  14. Antibiotic inclusion in the diet did not alter the standardized ileal digestible tryptophan to lysine ratio for growing pigs

    Science.gov (United States)

    Two 21-d experiments were conducted to determine the optimum standard ileal digestible (SID) Trp:Lys ratio in growing pigs fed diets supplemented with or without an antibiotic. The primary response variables in both experiments were ADG, ADFI, G:F and plasma urea N (PUN) concentrations with the opti...

  15. Ileal endogenous nitrogen recovery is increased and its amino acid pattern is altered in pigs fed quebracho extract

    NARCIS (Netherlands)

    Steendam, C.A.; Tamminga, S.; Boer, H.; Jong, de E.J.; Visser, G.H.; Verstegen, M.W.A.

    2004-01-01

    Ileal endogenous nitrogen recovery (ENR) in pigs (9 ± 0.6 kg body weight) was estimated simultaneously using the 15N-isotope dilution technique (15N-IDT) and the peptide alimentation ultrafiltration (UF) method. Diets were cornstarch, enzyme-hydrolyzed casein with no (control) or high (4%) content

  16. Development of ileal cytokine and immunoglobulin expression levels in response to early feeding in broilers and layers

    NARCIS (Netherlands)

    Simon, K.; Vries Reilingh, de G.; Kemp, B.; Lammers, A.

    2014-01-01

    Provision of feed in the immediate posthatch period may influence interaction between intestinal microbiota and immune system, and consequently immunological development of the chick. This study addressed ileal immune development in response to early feeding in 2 chicken breeds selected for

  17. Ileal, colonic and total tract nutrient digestibility in dogs (Canis familiaris) compared with total tract digestibility in mink (Neovison vison).

    Science.gov (United States)

    Tjernsbekk, Maria Therese; Tauson, Anne-Helene; Ahlstrøm, Oystein

    2014-01-01

    Mink (Neovison vison) was studied as a model for the determination of ileal crude protein (CP) and amino acid (AA) digestibility in dogs (Canis familiaris). Apparent ileal digestibility (AID) and apparent colonic digestibility (ACD) in dogs and apparent total tract digestibility (ATTD) in dogs and mink were measured for dry matter (DM), main nutrients and AA. Standardised ileal digestibility (SID) of CP and AA in dogs was calculated. Twelve dogs and 12 mink divided into three groups were fed one out of three diets differing in CP digestibility. In dogs, AID of CP was lower (74.4%) than ATTD (83.5%) (p Digestibility of AA followed the same pattern, and, except for Thr and Ser, ATTD in mink was very close to SID in dogs. Also, AID was close to ATTD in mink for several AA. High correlations were found between methods for digestibility of CP and most AA (p digestibility level (p digestibility was approximately 96% at all sites, while DM, starch and total carbohydrate digestibility increased from ileal to faecal level (p < 0.01). Mink ATTD of DM and main nutrients was closest to ACD in dogs. It was concluded that mink is a suitable model for the determination of AID and SID of CP and AA in dogs.

  18. Nitrogen utilization in pigs fed diets with soybean and rapeseed products leading to different ileal endogenous nitrogen losses

    NARCIS (Netherlands)

    Grala, W.; Verstegen, M.W.A.; Jansman, A.J.M.; Huisman, J.; Wasilewko, J.

    1998-01-01

    Nitrogen (N) balance was determined in 36 pigs (BW 24 to 30 kg) fed diets inducing different ileal endogenous N losses (ENL). We tested the hypothesis that enhanced ENL may be indicative of a higher recycling of endogenous proteins that will induce a greater urinary N loss and a lower efficiency of

  19. Standardized ileal digestible tryptophan to lysine ratios in growing pigs fed corn-based and non-corn-based diets

    Science.gov (United States)

    Two 21-d experiments were conducted to determine the optimum standard ileal digestible (SID) Trp:Lys ratio in growing pigs fed corn-based diets compared to non-corn-based diets. The primary response variables in both experiments were ADG and plasma urea N (PUN) concentrations with the optimum SID Tr...

  20. Pouchitis-Associated Iritis (Uveitis Following Total Proctocolectomy and Ileal Pouch-to-Anal Anastomosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    2001-01-01

    Full Text Available A 26-year-old woman with ulcerative colitis treated with a proctocolectomy and ileal pouch-to-anal anastomosis developed an erosive and ulcerative pouchitis. Although no ophthalmological manifestations were present before the staged surgical procedures, iritis developed after appearance of the pouchitis. Both conditions subsequently resolved with oral corticosteroids and metronidazole.

  1. Pre- and postjunctional effects of clonidine-and oxymetazoline-like compounds in guinea-pig ileal preparations

    OpenAIRE

    Malta, E.; Raper, C.; Tawa, Pauline E.

    1981-01-01

    1 Noradrenaline and 28 imidazolidine (clonidine-like) and imidazoline (oxymetazoline-like) compounds with various phenyl ring substituents have been examined for their ability to inhibit responses to transmural stimulation and exogenous acetylcholine in ileal preparations from reserpine-treated guinea-pigs.

  2. Early Transcriptomic Changes in the Ileal Pouch Provide Insight into the Molecular Pathogenesis of Pouchitis and Ulcerative Colitis

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yong; Dalal, Sushila; Antonopoulos, Dionysios; Hubert, Nathaniel; Raffals, Laura H.; Dolan, Kyle; Weber, Christopher; Messer, Jeannette S.; Jabri, Bana; Bendelac, Albert; Eren, A. Murat; Rubin, David T.; Sogin, Mitch; Chang, Eugene B.

    2017-01-01

    Background: Ulcerative colitis (UC) only involves the colonic mucosa. Yet, nearly 50% of patients with UC who undergo total proctocolectomy with ileal pouch anal anastomosis develop UC-like inflammation of the ileal pouch (pouchitis). By contrast, patients with familial adenomatous polyposis (FAP) with ileal pouch anal anastomosis develop pouchitis far less frequently. We hypothesized that pathogenic events associated with the development of UC are recapitulated by colonic-metaplastic transcriptomic reprogramming of the UC pouch. Methods: We prospectively sampled pouch and prepouch ileum mucosal biopsies in patients with UC with ileal pouch anal anastomosis 4, 8, and 12 months after their pouch was in continuity. Mucosal samples were also obtained from patients with FAP. Transcriptional profiles of the UC and FAP pouch and prepouch ileum were investigated via RNA sequencing and compared with data from a previously published microarray study. Results: Unlike patients with FAP, subjects with UC exhibited a large set of differentially expressed genes between the pouch and prepouch ileum as early as 4 months after pouch functionalization. Functional pathway analysis of differentially expressed genes in the UC pouch revealed an enhanced state of immune/inflammatory response and extracellular matrix remodeling. Moreover, >70% of differentially expressed genes mapped to published inflammatory bowel diseases microarray data sets displayed directional changes consistent with active UC but not with Crohn's disease. Conclusions: The UC pouch, well before histologic inflammation, already displays a systems-level gain of colon-associated genes and loss of ileum-associated genes. Patients with UC exhibit a unique transcriptomic response to ileal pouch creation that can be observed well before disease and may in part explain their susceptibility to the development of pouchitis.

  3. Ileal Amino Acid Digestibility of Broken Rice Fed to Postweaned Piglets with or without Multicarbohydrase and Phytase Supplementation

    Directory of Open Access Journals (Sweden)

    J. C. Dadalt

    2016-10-01

    Full Text Available Most of amino acid (AA digestibility values for feed ingredients are obtained using pigs cannulated in the distal ileum. The ileal-cannulated pig model uses pigs older than six weeks due to difficulties related to implanting the T-cannula in distal ileum of younger pigs and complications during the post-surgical recovery. However, to properly formulate the diet of weaned pigs, the nutritive value of feed ingredients should be determined with younger pigs. Thus, 25 weaned pigs were used to determine the apparent total tract digestibility (ATTD of nutrients, energy, and apparent ileal digestibility (AID and standardized ileal digestibility (SID ileal AA digestibility of broken rice (BR, with or without multicarbohydrase (MC and phytase (Phy supplementation. Piglets were weaned at 23 d of age and individually housed in digestibility cages until 45 d of age. The trial consisted of 7 d of adaptation to the experimental diets and 3 d of excreta (feces and urine collection. Ileal digesta was collected at slaughter (about 6 weeks of age. A completely randomized experimental design was used to determine the effects of MC and Phy. Reference diets (RD, 5% casein was replaced by 30% of BR with or without MC, Phy, or MC+Phy. The RD was used to quantify endogenous AA losses. BR with Phy supplied had increased the ATTD of dry matter (p<0.05 and SID of histidine (p = 0.05, arginine, leucine, lysine, valine, alanine, and proline (p<0.05. BR with MC had been increased digestible energy and protein and SID for histidine (p<0.05. There was no interaction between Phy and MC on the BR nutrient digestibilities. Standardized amino acid digestibilities of BR, without enzymes, were lower than those values reported in the literature. The MC and Phy improved the digestibility of some nutrients and energy of BR in post-weaned piglet diets.

  4. Risk adjustment is crucial in comparing outcomes of various surgical modalities in patients with ileal perforation

    Directory of Open Access Journals (Sweden)

    Arya Satyavrat

    2008-11-01

    Full Text Available Abstract Background Using crude mortality and morbidity rates for comparing outcomes can be misleading. The aim of the present study was to compare the outcome of various surgical modalities without and with risk adjustment using Physiologic and Operative Severity Scoring for the enUmeration of Mortality and morbidity (POSSUM score in cases of ileal perforations. Methods Prospective study on 125 patients of ileal perforations. Resection anastamosis (Group I was done in 38 patients, primary repair (Group II in 42 patients and 45 patients had an ileostomy (Group III. The disease severity was assessed in all patients using POSSUM score. The odds of death without and with risk adjustment using POSSUM mortality score were calculated for all groups Results Seventeen patients (14% patients died and 99 (79% developed postoperative complications. Using crude mortality rates Group I appeared to be the best treatment option with only 2 (5% deaths followed by Group II with 5 (12% deaths where as Group III had the worst outcome with 10 deaths (22%. However, Group III (ileostomy patients had higher mean POSSUM mortality and morbidity score (55.55%, 91.33% than Group I (28%, 75.26% and Group II (27%, 73.59%. Taking Group I as the reference (odds ratio, OR1 odds of death were greatest in Group III (OR 5.14, p = 0.043 followed by Group II (OR 2.43, p = 0.306. With risk adjustment using POSSUM mortality score the odds of death decreased in Group III (OR 1.16 p = 0.875. For the whole group, there was a significant association between the POSSUM score and postoperative complications and deaths. Mean POSSUM mortality and morbidity score of those who died (63.40 vs.33.68, p = 0.001 and developed complications (66.32 vs.84.20, p = 0.001 was significantly higher. For every percent increase in severity score the risk of postoperative complications and death increased by 1.10 (p = 0.001 and1.06 (p = 0.001 respectively. Conclusion Despite ileostomy patients having highest

  5. CONTAINER TERMINALS IN EUROPE

    Directory of Open Access Journals (Sweden)

    Bart W. WIEGMANS

    2001-01-01

    Full Text Available This paper aims to address the linkage between logistics (in particular, the management of marketing channel flows and transport markets, while also the interaction between these two markets and intermodal container terminals is analysed. The marketing channel theory is used to describe all relevant actors and flows that run through marketing channels, starting with customer needs and ending with customer satisfaction. Porter's theory of competitive advantages is used to review competitive forces in both markets. Finally, a competitor analysis is performed for the logistics and transport market. These theories are applied so as to be able to determine the competitive position of intermodal container terminals with a view to the management of marketing channel flows and the physical transport of freight flows. Hence, the central question of this paper is: Which markets are served by intermodal container terminals and with whom are they competing? At present, neither the maritime container terminals nor the continental container terminals appear to have a significant influence in the logistics service market; they concentrate mainly on the physical movement of containers (transshipment. Furthermore, maritime container terminals and continental container terminals are not dominant players in the transport service market. Our conclusion is that continental terminals are predominantly competing with unimodal road transport, with neighbouring continental terminals and with barge transport companies.

  6. Metabolizable energy, nitrogen balance, and ileal digestibility of amino acids in quality protein maize for pigs

    Science.gov (United States)

    2014-01-01

    Background To compare the nutritional value and digestibility of five quality protein maize (QPM) hybrids to that of white and yellow maize, two experiments were carried out in growing pigs. In experiment 1, the energy metabolizability and the nitrogen balance of growing pigs fed one of five QPM hybrid diets were compared against those of pigs fed white or yellow maize. In experiment 2, the apparent and standardized ileal digestibility (AID and SID, respectively) of proteins and amino acids from the five QPM hybrids were compared against those obtained from pigs fed white and yellow maize. In both experiments, the comparisons were conducted using contrasts. Results The dry matter and nitrogen intakes were higher in the pigs fed the QPM hybrids (P digestibility (P digestible lysine than normal maize. PMID:25045520

  7. Enhanced ileal absorption of a hydrophilic macromolecule, pentosan polysulfate sodium (PPS).

    Science.gov (United States)

    Dong, Liang; Yum, Alicia; Nguyen, Joe; Wong, Pat

    2004-01-01

    An in situ gelling, bioadhesive liquid formulation was developed to enhance the bioavailbility (BA) of a polysaccharide, pentosan polysulfate sodium (PPS). The formulation was tested to determine its bioavailability enhancement in a non-flush/non-ligated rat ileal model. A potent synergistic effect was found with a gelling agent Cremophor and a permeation enhancer sodium salicylate. The absolute bioavailabilities were 1.9%, 4.6%, 6.3% and 46.4%, respectively, for the PPS solution in saline, sodium salicylate/PPS, Cremophor/PPS and Cremophor/sodium salicylate/PPS. Therefore, we successfully demonstrated the approach of utilizing an in situ gelling/bioadhesive liquid carrier to enhancing the bioavailability of a hydrophilic macromolecule at the distal small intestine.

  8. Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

    Science.gov (United States)

    Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

    2015-01-01

    Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA). PMID:26195886

  9. Hand-assisted hybrid laparoscopic-robotic total proctocolectomy with ileal pouch--anal anastomosis.

    Science.gov (United States)

    Morelli, Luca; Guadagni, Simone; Mariniello, Maria Donatella; Furbetta, Niccolò; Pisano, Roberta; D'Isidoro, Cristiano; Caprili, Giovanni; Marciano, Emanuele; Di Candio, Giulio; Boggi, Ugo; Mosca, Franco

    2015-08-01

    Few studies have reported minimally invasive total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). We herein report a novel hand-assisted hybrid laparoscopic-robotic technique for patients with FAP and UC. Between February 2010 and March 2014, six patients underwent hand-assisted hybrid laparoscopic-robotic total proctocolectomy with IPAA. The abdominal colectomy was performed laparoscopically with hand assistance through a transverse suprapubic incision, also used to fashion the ileal pouch. The proctectomy was carried out with the da Vinci Surgical System. The IPAA was hand-sewn through a trans-anal approach. The procedure was complemented by a temporary diverting loop ileostomy. The mean hand-assisted laparoscopic surgery (HALS) time was 154.6 (±12.8) min whereas the mean robotic time was 93.6 (±8.1) min. In all cases, a nerve-sparing proctectomy was performed, and no conversion to traditional laparotomy was required. The mean postoperative hospital stay was 13.2 (±7.4) days. No anastomotic leakage was observed. To date, no autonomic neurological disorders have been observed with a mean of 5.8 (±1.3) bowel movements per day. The hand-assisted hybrid laparoscopic-robotic approach to total proctocolectomy with IPAA has not been previously described. Our report shows the feasibility of this hybrid approach, which surpasses most of the limitations of pure laparoscopic and robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages.

  10. Lentinan diminishes apoptotic bodies in the ileal crypts associated with S-1 administration.

    Science.gov (United States)

    Suga, Yasuyo; Takehana, Kenji

    2017-09-01

    S-1 is an oral agent containing tegafur (a prodrug of 5-fluorouracil) that is used to treat various cancers, but adverse effects are frequent. Two pilot clinical studies have suggested that lentinan (LNT; β-1,3-glucan) may reduce the incidence of adverse effects caused by S-1 therapy. In this study, we established a murine model for assessment of gastrointestinal toxicity associated with S-1 and studied the effect of LNT. S-1 was administered orally to BALB/c mice at the effective dose (8.3mg/kg, as tegafur equivalent) once daily (5days per week) for 3weeks. Stool consistency and intestinal specimens were examined. We investigated the effect of combined intravenous administration of LNT at 0.1mg, which is an effective dose in murine tumor models. We also investigated the effect of a single administration of S-1. During long-term administration of S-1, some mice had loose stools and an increase in apoptotic bodies was observed in the ileal crypts. An increase in apoptotic bodies was also noted after a single administration of S-1 (15mg/kg). Prior or concomitant administration of LNT inhibited the increase in apoptotic bodies in both settings. Administration of LNT also increased the accumulation of CD11b + TIM-4 + cells in the ileum, while depletion of these cells by liposomal clodronate diminished the inhibitory effect of LNT on S-1 toxicity. Combined administration of LNT with S-1 led to a decrease in apoptotic bodies in the ileal crypts, possibly because LNT promoted phagocytosis of damaged cells by CD11b + TIM-4 + cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Single Anastomosis Sleeve Ileal Bypass: New Step in the Evolution of Bariatric Surgeries.

    Science.gov (United States)

    Salama, Tamer M S; Sabry, Karim; Ghamrini, Yaser El

    2017-10-01

    Single anastomosis sleeve ileal bypass (SASI) procedure appears as a new metabolic and bariatric surgery based on Santoro's operation, in which a sleeve gastrectomy is followed by a side-to-side gastroileal anastomosis. The study is aimed to evaluate the short-term outcomes of laparoscopic single anastomosis sleeve ileal bypass with respect to postoperative weight loss and metabolic and nutritional effects on patients. Forty-five morbidly obese patients with a mean age of 31.2 years and a mean body mass index (BMI) of 43.2 kg/m 2 underwent SASI bypass. Postoperatively, all patients were followed up at 1, 3, 6, and 12 months, and during each visit data about their BMI, obesity-related comorbidities, and nutritional status were collected. One year after the surgery, mean BMI decreased to 29.1 kg/m 2 and there was significant decrease in plasma level of fasting blood glucose, insulin, and low-density lipoprotein. On the other hand, there was significant increase in high-density lipoprotein plasma level, whereas hemoglobin and albumin plasma level remained normal. Six months after the surgery, calcium plasma level showed mild decrease in two cases, which was improved with multivitamin tablets. In 93% of our patients, multivitamin supplements were stopped after six months of surgery. Laparoscopic SASI bypass has been shown to be an effective, safe, and simple procedure for the treatment of morbid obesity and its associated metabolic consequences. Moreover, it results in minimal postoperative nutritional complications in comparison to other bariatric procedures.

  12. Detection of epithelial apoptosis in pelvic ileal pouches for ulcerative colitis and familial adenomatous polyposis

    Directory of Open Access Journals (Sweden)

    Velloso Lício A

    2010-01-01

    Full Text Available Abstract Background Ileal pouch-anal anastomosis (IPAA is the surgical procedure of choice for patients with refractory ulcerative colitis (UC and for familial adenomatous polyposis (FAP with many rectal polyps. Pouchitis is one of the more frequent complications after IPAA in UC patients; however, it is rare in FAP. Objective Evaluate pro-apoptotic activity in endoscopically and histological normal mucosa of the ileal pouch in patients with UC and FAP. Methods Eighteen patients (nine with UC and nine with FAP with J pouch after total rectocolectomy were studied. Biopsies were obtained from the mucosa of the pouch and from normal ileum. The specimens were snap-frozen and the expressions of Bax and Bcl-2 were determined by immunoblot of protein extracts and by immunohistochemistry analysis. FADD, Caspase-8, APAF-1 and Caspase-9 were evaluated by immunoprecipitation and immunoblot. Results Patients with UC had significantly higher protein levels of Bax and APAF-1, Caspase-9 than patients with FAP, but were similar to controls. The expressions of Bcl-2 and FADD, Caspase-8 were similar in the groups. Immunohistochemistry for Bax showed less intensity of immunoreactions in FAP than in UC and Controls. Bcl-2 immunostaining was similar among the groups. Conclusion Patients with FAP present lower levels of pro-apoptotic proteins in all methods applied, even in the absence of clinical and endoscopic pouchitis and dysplasia in the histological analysis. These findings may explain a tendency of up-regulation of apoptosis in UC patients, resulting in higher rates of progression to pouchitis in these patients, which could correlate with mucosal atrophy that occurs in inflamed tissue. However, FAP patients had low pro-apoptotic activity in the mucosa, and it could explain the tendency to low cell turn over and presence of adenomas in this syndrome.

  13. ILEAL HERNIATION THROUGH THE FORAMEN OF WINSLOW: OVEREATING AS A RISK FACTOR FOR INTERNAL HERNIATION.

    Science.gov (United States)

    Kirigin, Lora Stanka; Nikolić, Marko; Kruljac, Ivan; Marjan, Domagoj; Penavić, Ivan; Ljubicić, Neven; Budimir, Ivan; Vrkljan, Milan

    2016-03-01

    Internal hernias have an overall incidence of less than 1% and are difficult to diagnose clinically due to their nonspecific presentation. Most internal hernias present as strangulating closed-loop obstruction and delay in surgical intervention is responsible for a high mortality rate (49%). We present a case of ileal herniation through the foramen of Winslow. A 29-year-old previously healthy female presented with acute onset right upper quadrant pain, abdominal fullness, and nausea. The pain was sudden in onset and began shortly after a dinner party where she consumed larger portions of food. Laboratory investigations revealed mild leukocytosis with left shift. Dual-phase multi-detector computed tomography disclosed herniation of the small bowel into the lesser sac. The patient underwent an emergency median laparotomy that revealed ileal herniation through the foramen of Winslow. Adhesiolysis and manual reduction of the bowel was performed, and the reduced bowel showed only congestive changes. The postoperative recovery was uneventful and the patient was discharged on the third postoperative day. Risk factors for internal herniation still remain unclear, although excessively mobile bowel loops and an enlarged foramen of Winslow have been described. Our case demonstrated that overeating could be an additional risk factor for internal herniation. We describe our clinical and radiology findings, as well as surgical management. Due to the high rates of morbidity and mortality, it is imperative that clinicians be aware of the possible risks factors for internal herniation. Internal hernias should be included in the differential diagnosis of small bowel obstruction so that appropriate steps can be made in the work-up of these patients, followed by timely surgical intervention.

  14. Mappings of terminal continua

    Directory of Open Access Journals (Sweden)

    Janusz J. Charatonik

    2002-01-01

    Full Text Available The concept of a terminal continuum introduced in 1973 by G. R. Gordh Jr., for hereditarily unicoherent continua is extended to arbitrary continua. Mapping properties of these two concepts are investigated. Especially the invariance of terminality under mappings satisfying some special conditions is studied. In particular, we conclude that the invariance holds for atomic mappings.

  15. Managing terminal restlessness

    African Journals Online (AJOL)

    Repro

    compounded by the memory of unre- lieved suffering. ... progressive impairment of memory, judge- ment and thinking. ... of palliative sedation for refractory symp- toms in dying patients. Managing terminal restlessness. Terminal restlessness presents many challenges, not least recognition of the problem and its. c a u s e s .

  16. Gastroduodenal and ileal polyps in patients treated surgically for familial polyposis coli with proctocolectomy and continent ileostomy.

    Science.gov (United States)

    Ojerskog, B; Myrvold, H E; Nilsson, L O; Philipson, B M; Ahrén, C

    1987-01-01

    Eighteen patients, who previously had been treated surgically for familial polyposis coli with proctocolectomy and a continent ileostomy were re-investigated with endoscopy and X-ray for gastric, duodenal and ileal polyps. Gastric and/or duodenal polyps were found in 6 patients and ileal polyps in 2. Altogether upper GI-polyps were found in 7 patients (39%). Most polyps were true adenomas. In one patient with large gastric adenomas, the severe dysplasia called for a gastric resection. It is obvious that familial polyposis may affect the whole gastro-intestinal tract, therefore necessitating regular surveillance of the upper GI-canal as well as the colon and rectum in patients with this hereditary affliction.

  17. Ileal Diverticulitis as a Cause of Right Lower Quadrant Pain: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    P. Kothadia

    2015-12-01

    Full Text Available Introduction Small bowel diverticulitis is a rare clinical disease of the small bowel. The incidence of small bowel diverticulitis varies from 0.3 to 2.3 % in the general population. Complications of this rare clinical entity are often confused with other causes of acute abdomen such as acute appendicitis, perforated peptic ulcer, inflammatory bowel disease or ischemic bowel disease. Case Presentation We describe a 65-year-old male with a history of ileal diverticulosis who presented with acute abdomen and was subsequently found to have perforated ileal diverticulitis with abscess formation. Conclusions The case, differential diagnosis, imaging studies, complications and management of this rare clinical disease are discussed.

  18. Radical cystectomy and pelvic lymphadenectomy with ileal conduit urinary diversion and abdominal wall reconstruction: an interesting case of multidisciplinary management

    Directory of Open Access Journals (Sweden)

    Sofos SS

    2015-01-01

    Full Text Available Stratos S Sofos,1 Ciaran Walsh,2 Nigel J Parr,2 Kevin Hancock11Whiston Hospital, Prescot, 2Arrowe Park Hospital, Wirral, Merseyside, UKAbstract: The ileal conduit for urinary diversion after radical cystectomy is a well-described procedure. Furthermore, parastomal hernias, prolapse, stenosis, and retraction of the stoma have been reported as some of the more common complications of this procedure. The subsequent repair of parastomal hernias with a biological mesh and the potential of the conduit to “tunnel” through it has also been described. In this case report, we present a combined repair of a large incisional hernia with a cystectomy and a pelvic lymphadenectomy for invasive bladder cancer, with the use of a biological mesh for posterior component abdominal wall primary repair as well as for support to the ileal conduit used for urinary diversion.Keywords: incisional hernia, posterior component separation, biological mesh 

  19. Composition of Ileal Bacterial Community in Grazing Goats Varies across Non-rumination, Transition and Rumination Stages of Life.

    Science.gov (United States)

    Jiao, Jinzhen; Wu, Jian; Zhou, Chuanshe; Tang, Shaoxun; Wang, Min; Tan, Zhiliang

    2016-01-01

    The establishment of gut microbiota is increasingly recognized as a crucial action in neonatal development, host health and productivity. We hypothesized that the ileal microbiome shifted as goats matured, and this colonization process would be associated with host fermentation capacity. To this end, 18 Liuyang black grazing goats were randomly slaughtered at d 0, 7, 28, 42, and 70. Ileal microbiota was profiled by Miseq sequencing of 16S rRNA gene of bacteria, and fermentation capacity [volatile fatty acid, activities of amylase, carboxymethylcellulase (CMCase) and xylanase] was determined using digesta sample. Principal coordinate analysis revealed that each age group harbored its distinct bacteria. Total bacteria copy number and most alpha diversity indexes increased (P grazing goats assemble into distinct communities throughout development, and might participate in the improvement of host fermentation capacity.

  20. Nonleaking battery terminals.

    Science.gov (United States)

    Snider, W. E.; Nagle, W. J.

    1972-01-01

    Three different terminals were designed for usage in a 40 ampere/hour silver zinc battery which has a 45% KOH by weight electrolyte in a plastic battery case. Life tests, including thermal cycling, electrical charge and discharge for up to three years duration, were conducted on these three different terminal designs. Tests for creep rate and tensile strength were conducted on the polyphenylene oxide plastic battery cases. Some cases were unused and others containing KOH electrolyte were placed on life tests. The design and testing of nonleaking battery terminals for use with a KOH electrolyte in a plastic case are considered.